Preamble

The House met at Eleven o'Clock

PRAYERS

[Mr. SPEAKER in the Chair]

Orders of the Day — WAYS AND MEANS [27th October]

Resolution reported:

Orders of the Day — PROFITS TAX

"That the profits tax payable on distributed profits (and sums treated as such) shall be increased by—

(a) substituting as respects any chargeable accounting period ending after the end of September, nineteen hundred and forty-nine—

(i) thirty per cent. for twenty-five per cent, as the rate of any tax not being a distribution charge; and
(ii) twenty per cent. for fifteen per cent. as the rate of any relief for non-distribution and as that of any distribution charge;

(b) dividing for all or any purposes of the profits tax any accounting period of a body corporate, unincorporated society or other body falling partly before and partly after the end of that month into two chargeable accounting periods ending and beginning at the end of that month;
(c) treating dividends declared on or after the twenty-seventh of that month wholly or partly as a distribution for a chargeable accounting period ending after the end of that month;

and that any Act of the present Session giving effect to this Resolution may contain provisions consequential on or incidental to any of the foregoing provisions of this Resolution."

Resolution read a Second time.

Question, "That this House doth agree with the Committee in the said Resolution," put, forthwith, pursuant to Standing Order No. 86 (Ways and Means Motions and Resolutions), and agreed to.

Bill ordered to be brought in upon the said Resolution by the Chairman of Ways and Means, the Chancellor of the Exchequer and Mr. Glenvil Hall.

Orders of the Day — BILL PRESENTED

PROFITS TAX BILL,

"to increase the profits tax payable on distributed profits and sums treated as such,"—presented accordingly, and read the First time; to be read a Second time upon Monday next, and to be printed. [Bill 192.]

Orders of the Day — NURSES [MONEY]

Resolution reported:
That, for the purposes of any Act of the present Session to reconstitute the General Nursing Council for England and Wales (hereinafter referred to as "the Council"), it is expedient to authorise the payment out of moneys provided by Parliament of—

(a) all expenses incurred by the Council with the approval of the Minister of Health which are attributable to defraying expenditure incurred by standing nurse-training committees constituted under the said Act;
(b) any contributions made by the Minister of Health towards the expenses of the Council in inspecting and approving, for the purposes of rules made by the Council relating to the training of nurses, institutions vested in him; and
(c) any fees or allowances paid by the Lord Chancellor to a person nominated by him under the said Act to determine an appeal against a refusal of the Council to approve an institution for the purposes of any such rules as aforesaid or a withdrawal by the Council of approval given by them for those purposes to an institution."

Resolution agreed to.

Orders of the Day — NURSES BILL [Lords]

Considered in Committee.

[Mr. BOWLES in the Chair]

Clause 1.—(RECONSTITUTION OF THE GENERAL NURSING COUNCIL AND CONSEQUENTIAL PROVISIONS.)

11.7 a.m.

Mr. Linstead: I beg to move, in page 2, line 7, after "Committee" to insert:
(which shall hereinafter be referred to as the Enrolled Nurses Committee).
This Amendment is the first of a number dealing with the same general question: namely, whether it is possible to give an assistant nurse the statutory title of "enrolled nurse," instead of, as at present, giving her the statutory title of "assistant nurse" while at the same time giving her the legal right to call herself a nurse. At the moment there is


an anomaly, because although these nurses are on a roll called the "Roll of Assistant Nurses" they have the right to call themselves nurses without the word "assistant" in front of it. This Amendment is designed to cure that anomaly.
One recognises that this at once raises the question of what to call a State registered nurse, who is of course a registered nurse as distinct from an enrolled assistant nurse. Nevertheless, it seems to me that it would be better to have the anomaly that in an Act of Parliament, and nowhere else, the enrolled assistant nurse was called an enrolled nurse and the State registered nurse was called a registered nurse than to have the present anomaly of somebody being given a statutory title and yet being entitled to be called by something quite distinct from that title.
I am sure that if this change is made it will enhance the standing of the assistant nurse; and it will attract girls to take up nursing who otherwise would not do so because they would not be prepared for the long period of training for an examination in order to become State registered. We must remember that, whether we like it or not, many of our hospitals, particularly the hospitals for the chronic sick, will be staffed by these assistant nurses. Anything which can be done to encourage girls to become assistant nurses and to give them the status which will bring them under the control of the General Nursing Council either as assistant or enrolled nurses, should be done. It will in particular help in staffing the hospitals for the chronic sick.
I hope that the Parliamentary Secretary will not turn down this Amendment out of hand. I believe that it is worth further consideration. If he is able to accept it, and to persuade the State registered nurses to accept it, I seriously suggest that it will help to solve the difficult question of recruiting.

Mrs. Leah Manning: I have a very great deal of sympathy with the object of the Amendment, but I would like to hear from the Parliamentary Secretary before I decide how to vote, particularly whether there are objections from the nurses or from the General Nursing Council. We ought to do something to help women who want

to be assistant nurses because they do not feel that they can stand the strain of the whole course. There are large numbers of women who are already assistant nurses and who, because of the anomalous position which they occupy in the hospitals, will not go fully into the nursing service. Much could be done to help these women, who are in many cases experienced and sympathetic. I had a letter from one girl this morning who says that in her hospital she is not allowed to wear a cap and is not allowed to give an aperient. I doubt whether the conditions in many of these cases would be changed if we changed their name.
I hope, as a result of many things which will now happen in regard to examinations and training, that we shall remove some of the difficulties which confront girls who have not a very high academic ability but who have a real desire to nurse. The answer lies in shorter training and an easy examination at the end of it after, say, two years, and then to add to it all the other qualifications which one hopes that a fully-trained and qualified nurse would get. I hope we shall all feel that something has to be done about this question of the assistant nurse.

Mr. Diamond: I, too, have every sympathy with what was said by the hon. Member for Putney (Mr. Linstead), but I do not think that the Amendment will achieve what is in the hearts of many of us. We desire every possible encouragement to be given to the nursing profession, but I do not think that the proposed alteration of title, which will be laid down from above as it were without anything like adequate consultation with members of the nursing profession, will do anything other than create harm. It is admitted that the title "assistant nurse" has defects. The hon. Gentleman says, "That is anomalous. Let us have a rather different and less anomalous anomaly."
I do not think that we would be doing our best service by removing one anomaly and putting in another one, especially when it does not achieve what I regard as the three essential things. It does not rest on the desire of the whole nursing profession, for the simple reason that they have not had a chance of considering it. It does not make a very clear distinction in the lay mind between the two categories


of nurse. Thirdly—and I hope that I am not being in any way disrespectful—it is of no relevance in defining the quality of the nurses. It merely defines whether the nurse goes on a register or on a roll.
The real point is to have some definition of the type and quality of the nurse, whether she is a fully qualified nurse or—and then one is stuck for a title. One must say "assistant nurse." Having regard to those points I hope that the Parliamentary Secretary will not at this stage give his support to the Amendment. If this matter were allowed to be discussed generally in the course of the next three to five years, perhaps the problem would solve itself.

Mr. Sorensen: I am sure that we all sympathise with the intention of the mover of the Amendment. I am sure also that many excellent nurses feel humiliated by being restricted in the work that they can do in their nursing functions, and by having to accept a title which seems to them to be unnecessarily a sign of inferiority. I hope that some attempt will be made to discover a more suitable title than "assistant nurse." She is a nurse, and not merely an assistant. Just as "a rose by any other name would smell as sweet," so the term suggested in the Amendment would cause the same trouble as the existing term. Therefore, the proposal is unattractive.
One part of the intention of the mover is to secure a larger number of those who would perform this function, heretofore known as that of assistant nurse. By calling these nurses "enrolled nurses" we shall not get any more of them. The problem is much deeper than that. We can put aside any assumption that by altering the name we shall get more recruits. That leaves us with the difficulty whether we can find some term which is less mildly offensive than "assistant nurse." As yet, the Minister has not discovered one and the hon. Member for Putney (Mr. Linstead) has not discovered one either. For those reasons I cannot support the Amendment.

11.15 a.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop): I must add my word of sympathy with the object of the Amendment to those that have been expressed on this side of the Committee. We do not regard

the term "assistant nurse" as being a final choice of especial value. I must agree with my hon. Friends who have spoken and who have suggested that we have not yet been able to find any suitable alternative. My hon. Friend the Member for Epping (Mrs. Manning) suggested that we wanted, as indeed we do, to recruit more nurses, both assistant and fully qualified. She suggested that we must look to simplification of training for certain categories of nurses. We have recently shortened the period of training for assistant nurses, and for that very reason this is perhaps rather a bad moment to choose for suggesting a new name, which would, in the mind of the ordinary general public, cause rather more confusion.
It would be difficult for the average person to differentiate between enrolled nurses and registered nurses. For that reason, among others, we would, not be able to accept the Amendment and the consequential Amendments that are on the Order Paper. At the same time, I would emphasise that we are very willing indeed to have general discussions and that, if at any future time we can find a name which will be more suitable and that will express the different job that has to be done and the different training that has been carried through without in any way reducing the status of the registered nurse—who has gone through a very long and arduous period of training—we shall be only too glad. I am afraid that the Amendment does not help us in that matter.

Mr. Linstead: Perhaps I may be allowed to make one or two comments on the sympathetic and helpful speeches to which the Committee have listened. I recognise that what I have done today is to begin an involved process, and although I would not take the period of time which the hon. Gentleman has suggested before it comes to fruition, I appreciate that the time is not ripe today.
I would like to comment briefly on the three objections which the hon. Member for Blackley (Mr. Diamond) raised. He said first that, so far as can be ascertained at very short notice, the proposed change was not the desire of the profession. The first point I want to emphasise is that it is an error to suggest that the profession of nursing is composed only of State registered nurses. If we


were to take a vote of the profession as represented by all those men and women who are engaged in nursing the sick, I am more than doubtful whether we should not find that there were more in favour of this proposal than against it.

Mr. Sorensen: Would not the hon. Gentleman agree that the State registered nurse should form, so to speak, the criterion of all kinds of nursing?

Mr. Linstead: One might say the "aristocracy," but I would not necessarily say the "criterion."
The second point raised by the hon. Member for Blackley was that by changing the name we should be doing away with the distinction which at present exists. It is relevant to read from Section 6 of the Nurses Act, 1943, the following words, which have a bearing on that question:
…. any person who, not being a duly registered nurse under the principal Act or a duly enrolled assistant nurse, takes or uses the name or title of nurse … shall be liable …
In other words, that Section does away with any distinction except a distinction of laymen for the purposes of the Statute. I am advocating that what is declared in that Section shall in due course be made still clearer by the actual title which is bestowed upon those concerned.
The hon. Member said, finally, that the Amendment would have no relevance in defining the quality of the nurses. It has, at least, this considerable relevance. The people of whom we are speaking are nurses, actually engaged in nursing, and I think that that statement was a mistake. We are not defining the quality of the nurse by calling her an assistant nurse, because in a very large number of hospitals she is, in fact, the nurse. She may be acting as an assistant to a sister, for instance; not as an assistant nurse, but as a nurse.
As we gradually begin to examine this problem and bring it forward into the light of day, there is more to be said for the point of view I have put forward. In view, however, of the expressions of opinion which we have heard, I will not pursue the matter further now, but I hope that there will be other opportunities when the same point can be discussed,

particularly among the profession itself. In the circumstances, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.

Clause 2.—(STANDING NURSE-TRAINING COMMITTEES.)

Mr. Blenkinsop: I beg to move, in page 2, line 27, to leave out from "Minister," to "constitute," in line 28, and to insert "shall by order."
In moving this Amendment, to which there is a consequential Amendment, I appreciate that there was already on the Order Paper an Amendment with this purpose. We felt it desirable to put down our Amendment in slightly different words to achieve the same object: namely, to ensure that it is understood that it is the intention that the Minister shall set up a standing nurse training committee in each region and that it will not be left to his discretion whether or not he shall do so. That doubt was expressed during Second Reading.

Sir Hugh Lucas-Tooth: I am glad that the Government have seen fit to put down their two Amendments. They cover, of course, precisely the point which is covered by the Amendment which stands in the names of hon. Members on this side. I do not know why the Government have chosen a more complicated method, but, in view of what the Parliamentary Secretary has said, we need not pursue the matter further, except to express our gratitude for the change which has taken place.

Amendment agreed to.

The following Amendment stood upon the Order Paper in the names of Lieut.-Colonel ELLIOT and other hon. Members:

In page 2, line 30, leave out "standing nurse-training committee," and insert "nurse-training authority."

The Deputy-Chairman (Mr. Bowles): I have had to consider whether this Amendment, on which hang a large number of consequential Amendments, is within the Money Resolution. Paragraph (a) allows
expenditure incurred by standing nurse training committees constituted under the said Act.


The right hon. and gallant Gentleman wishes to change the name of these committees to "nurse-training authority." This seems literally to alter the destination of the grant, but in view of the fact that the right hon. and gallant Gentleman is not proposing to alter the functions of the committees, but only their name, I do not think the Amendment can be said to extend the object or purpose or relax the conditions and qualifications expressed in the Money Resolution.
Before, therefore, calling the Amendment, I should like to be assured that there is no more in it than a mere change of name, otherwise I shall have to rule the Amendment out of Order. I must also point out that the Amendment is far from complete in that many of the necessary consequential Amendments are not on the Paper, and particularly the most irrinortant—namely, those to Clause 19 and the Second Schedule. That objection I am prepared also to disregard, as some of the consequential Amendments have been put down.

Mr. Assheton: I am much obliged to you, Mr. Bowles, for what you have said and I can certainly give you the assurance for which you ask.

Mr. Linstead: I beg to move, in page 2, line 30, to leave out "standing nurse-training committee," and to insert "nurse-training authority."
May I express my gratitude to you, Mr. Bowles, for giving that favourable Ruling? I seem to be a sort of godfather this morning, for this question also is one of nomenclature and christening, and I hope that the Parliamentary Secretary may be more well disposed towards this Amendment. The difficulty with which it deals is one to which I drew attention during Second Reading: namely, the best name to call the new nurse-training bodies. They cannot be called boards, because we already have the regional boards; neither can we call them councils because of the existence of the General Nursing Council, who propose to refer to these new bodies as "committees."
The real difficulty, particularly if these bodies operate territorially within regions, is that they may be regarded as subordinate bodies of the regional boards. Clearly, that is not so, although they

operate within the same areas. It is desirable, therefore, to find an alternative name to "committee" which indicates that they are autonomous bodies within their regions and operating on their own authority. Within the very limited range of nouns available, the name "authority" commends itself to the Royal College of Nursing, who suggest that that description puts the new bodies in their best perspective. I do not need to say anything further as the point is, I am sure, quite clear to the Parliamentary Secretary.

11.30 a.m.

Mr. Blenkinsop: Again, as the hon. Member for Putney (Mr. Linstead) has said, we are discussing a question of nomenclature, but that does not mean that it is not important. It is important to get as effective and useful a name as we can. I am not sure that we have a name here that meets our difficulties. It may clarify the point raised by the hon. Member for Putney that the use of the word "committee" may suggest that it is a committee of the regional hospital board, but the word "authority" raises new problems. The body that really is the training authority is presumably the hospital, and not this body which links, together the hospital where the training is being done with the General Nursing Council.
After thinking this over carefully, I have come to the conclusion that, while I appreciate the objective and welcome any discussion and consideration of this matter, I fear that it raises problems equal in difficulty to those we are trying to overcome. While not wishing to deter anyone from considering between now, and the Report stage any other noun that might be suitable, I feel we are not making any real advance by this suggestion, and for that reason I am not able to accept the Amendment.

Sir H. Lucas-Tooth: I appreciate what the Parliamentary Secretary has said, and I do not imagine that my hon. Friend will wish to press this matter further, in view of the hon. Gentleman's sympathetic tone. There is one point which has not yet been fully brought to the attention of the Committee, and that is the unfortunate use of the word "standing" in this connection. I may be regarded as facetious in saying that the juxta-


position of the word "standing" and "nurse" may lead to comments, but such comments should be avoided if possible in this connection. I do not see any particular use for the word "standing" here, and I suggest to the Government that if they cannot see their way to substitute some other word for "committee," they should consider the omission of the word "standing."

Mr. Skinnard: I reinforce the argument used by the hon. Member for South Hendon (Sir H. Lucas-Tooth) because the way out is either to use some such alternative as "permanent" in place of "standing" or to put the latter word where it naturally belongs, before the word "committee," so that it would be a "nurse-training standing committee," if only for the sake of the usual way of putting these things, and if we must have that objectionable term. It has caused a lot of hilarity in other connections for a number of years, and when we are trying to use as dignified a nomenclature as we can, why should we retain anything which might lead to further hilarity?

Mr. Howard: May I remind the Parliamentary Secretary that when this matter was raised in another place, the representative of the Government said:
I do not like the term 'standing nurse-training committee.' I do not think there will be objection to a change in name, if a suitable one can be found which will show the difference between the Council on the one hand, and the regional hospital boards on the other.
I do not press the point because I appreciate the difficulty in finding the right name, but it would be helpful if the Parliamentary Secretary would make perfectly clear the point raised by my hon. Friend the Member for Putney (Mr. Linstead) that these regional committees will not be subordinate to the regional hospital board but will be separate and distinct bodies with a separate and distinct function. If the hon. Gentleman will make that clear from the Treasury Bench, it will do as much as anything else to get over these difficulties.

Mr. Assheton: I hope the Parliamentary Secretary will be good enough to meet the point made so well by the hon. Member for Westminster, St. George's (Mr. Howard). In addition, I

am sure that the hon. Gentleman is sympathetic to the object of the Amendment and I believe that between now and the Report stage some solution may be found of this little problem. I hope, therefore, that when the hon. Gentleman replies he will say that between now and then he will do his best to find a solution.

Mr. Blenkinsop: I am only too willing to reply to the point made by the hon. Member for Westminster, St. George's (Mr. Howard). It is perfectly clear that these standing committees are entirely independent of the regional hospital boards. They will have upon them representatives of the regional hospital boards, as they will have representatives of the boards of governors of the teaching hospitals and others. It is quite clear, however, that they are quite independent and that there is no intention that they should be in any way committees of the regional hospital boards. On the use of the word "standing," I should have thought that "standing committee" was a dignified connotation because we have Standing Committees of this House—

Mr. Skinnard: Not Standing Members' Committees of this House.

Mr. Blenkinsop: I should not have thought that would have caused much difficulty. However, if we can think of any better phraseology to use, I shall be only too ready to consider it.

Mr. Linstead: In view of what the Parliamentary Secretary has said, and before the standing committees begin to sit, I hope we shall find another word to put before the hon. Gentleman and, in the light of that possibility, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Blenkinsop: I beg to move, in page 2, line 31, to leave out "that area," and to insert:
each hospital area; and before making an order under this subsection with respect to any such area the Minister shall consult with the Council.
This Amendment is consequential upon making these regional committees obligatory upon the Minister.

Amendment agreed to.

Mr. Diamond: I beg to move, in page 3, line 15, at the beginning, to insert:
The Council may subject to such conditions as they may think fit delegate authority to.


This Amendment deals with that part of the Clause under which the Council may authorise standing nurse-training committees to conduct examinations on behalf of the Council. The delegation of that authority is a matter upon which the Council must use the greatest possible circumspection and may desire to make the most precise and carefully-thought-out conditions. It is on the assumption that the present subsection does not necessarily give the Council power to make those conditions at the time of making the authority, that this Amendment is moved.

Mr. Blenkinsop: I do not think there is anything between us on this issue and it is really a matter of drafting. I am advised that there would be no restriction upon the General Nursing Council imposing any reasonable conditions in the use of this power, and it is obviously right that they should do so. Here, to some extent, we are departing from past practice and ensuring the right of regional committees to hold examinations. It is only proper that that should be done under such reasonable conditions as the General Nursing Council should decide and specify.
I am assured that there is no difficulty within the existing words of the Bill in providing for that, and that the General Nursing Council could in fact impose limitations of time, or such other conditions as they might wish. I am, however, quite prepared to look at the matter to make sure, but, from the information I have before me, it seems quite clear that the power is already there. For that reason, I do not think it necessary to accept the additional wording proposed by my hon. Friend.

Mrs. Manning: Would this allow the General Nursing Council to impose conditions of standardisation over the country?

Mr. Howard: I wish to support the view put forward by the hon. Member for Blackley (Mr. Diamond). It is most important that we should have clearly set out in the Bill that the question of what type of examination is to be carried out and the conditions under which it is to be carried out must be the responsibility of the supervising body of the General Nursing Council. It may be that the words in the Bill at present
if requested by the Council so to do

are adequate, but there are fears about it, not merely in the General Nursing Council, but throughout the whole nursing profession. I hope the Parliamentary Secretary will look at this again very carefully, because I am not entirely satisfied that the wording is right. In view of his undertaking that if the wording is found not to be right, better words will be introduced on Report stage, I do not wish to pursue the matter further.

Mrs. Manning: This makes me a little anxious, because I think that here, as in examinations for other professions, there must be some method of standardising, although that is not quite the word to describe what I mean. In the United States of America different examinations take place in different States and are not acceptable as between one State and another. We do not want a similar system here, as it might put one regional committee in a bad position compared with the rest. There must be the overall authority of the General Nursing Council on the question of standardisation, as well as on other conditions.

Mr. Somerville Hastings: I hope the Minister will look very carefully at this matter again. As we all know, there is a great shortage of nurses and we also know it might be possible for the regional hospital board in an area to speak with considerable authority on the standing nurse-training committee and use a good deal of influence. If in one region the standard of examination were to be reduced, it would perhaps be much easier for that authority to secure nurses. I agree that the nursing examination is much too theoretical at present and needs to be made much more practical, but I feel that the same standard should be maintained by all the standing nurse-training committees.

11.45 a.m.

Mr. Diamond: I am most grateful for the comments made on both sides of the Committee and those made by my hon. Friend the Parliamentary Secretary, because I think they have proved to the hilt the necessity of making clear beyond any doubt that the Nursing Council should have power to delegate authority to conduct examinations with the most precise conditions as to standardisation and standard of examination, and anything else which from experience they deem neces-


sary. The Parliamentary Secretary has said that he is assured that the words give the General Nursing Council the powers they seek by this Amendment, and he has also been good enough to make assurance doubly sure. I do not wish to detract one tittle from the assurance he gave us that he will be good enough to look into the matter yet again, and presumably if he finds his first assurance was not fully justified, he will be prepared at a later stage to bring in words which would serve the purpose on which, obviously, we are all agreed.

Mr. Blenkinsop: I wish to add a word. We have been satisfied that within the wording of the Bill as it stands, the General Nursing Council remains entirely responsible for examinations to be carried out and can standardise them throughout the country. The Clause refers to
any examination prescribed by rules made by the Council,
which reinforces my view that it is entirely within the power of the General Nursing Council in authorising the regional committee to carry out examinations to impose whatever conditions they consider desirable and necessary. I am quite willing between now and the Report stage to look at this again to make doubly sure that there is no difficulty in the matter.

Mr. Diamond: In view of that double assurance, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause, as amended, ordered to stand part of the Bill.

Clause 3 ordered to stand part of the Bill.

Clause 4.—(EXPENDITURE ON NURSE-TRAINING BY HOSPITAL MANAGEMENT COMMITTEES, ETC.)

Mr. Blenkinsop: I beg to move, in page 4, line 14, to leave out "or," and to insert "and expenditure."
This Amendment and the proposed Amendment to line 15 are of a drafting nature. It might be possible to consider the Clause as referring to a hospital management committee appointed by the board of a teaching hospital, although that is very unlikely.

Amendment agreed to.

Further Amendment made: In page 4, line 15, after "being," insert "in each case."—[Mr. Blenkinsop.]

Sir H. Lucas-Tooth: I beg to move, in page 4, line 25, to leave out subsection (2).
This is an important Amendment, and indeed I think it is the most substantial on the Amendment paper. I assure the Parliamentary Secretary that I do not move it dogmatically. I regard the Amendment as little more than drafting if the effect of the Clause is such as I imagine it to be, but I think it true to say that there is a great deal of doubt, not only among hon. Members but on the part of those who will have to operate the Bill, as to how it is intended that this Clause shall work. The purpose of the Bill as a whole is really centred on this Clause and is to separate the responsibility for the training of nurses from the employment of nurses.
It is quite clear from what was said on Second Reading that that purpose is completely agreed in all parts of the Committee; but we did not on Second Reading discuss the question of how that purpose was to be carried out. I invited the Parliamentary Secretary at that stage to give some indication of the way in which he contemplated that the machinery outlined in this Clause would work when it came to be put into operation. He, perhaps wisely, declined at that stage to go into the matter. We must now, however, on the Committee stage really ask the Government to tell us clearly what they think will be the way this scheme will actually work, not only for the purpose of considering amending this Bill but also to be some sort of guidance to those outside the House who are following these matters, and who will in due course have to try to give effect to the intentions of the House in passing this legislation.
The nurse-training committees are given the power and the obligation to do two things. The first is to lay down a training programme for nurses for the hospitals within their area. The second is to pay for the carrying out of that programme by funds which are ultimately derived from the Government through the Council. There are two questions which I wish to put to the Parliamentary Secretary on that matter, because they are extremely relevant to the general question


of the application of this Clause. The first is whether a hospital can do any training of nurses which has not previously been approved of by the nurse-training committee? I think that the Parliamentary Secretary indicated on Second Reading that a hospital could not do so. If that is the position, I am rather apprehensive that there may be some tendency to find that this scheme is what the Minister of Health would describe as muscle-bound.
The other question that I wish to ask the Parliamentary Secretary is whether all disbursements which fall to be made in respect of training will be made by the hospitals themselves or whether the nurse-training committee will be able to carry out the scheme within the walls of a hospitals? It is extremely important that the actual training should be carried out completely by the hospitals and that the only financial transaction should be the recoupment to the hospital of a total sum through the nurse-training committee.
The practical difficulty is due to the fact that there must be a large area of overlap between the training and employment of nurses; that is necessarily so from the nature of the problem. There will be a great deal of expenditure which is partly for training and partly for employment purposes. Where that overlap occurs and there are two different bodies responsible for policy and payment, there is obviously a danger of a real conflict. It is that which we should by this legislation seek to avoid and make as improbable as possible. The kind of question which occurs to me—here I cannot speak with the same knowledge as some of my hon. Friends or some hon. Members opposite who have experience of this matter otherwise than that as a governor of a hospital, which is all I have—is that a hospital might require 50 nurses in training for purposes of employment and the nurse-training committee might decide that for purposes of training only 30 nurses should be in training in that hospital. That is quite a possible circumstance. Both the hospital authority and the nurse-training committee might be right. In such a situation there will be a conflict which has somehow or other to be reconciled.
Supposing the nurse-training committee is able to say "You should not employ

more than 30 nurses in that hospital because you have not the proper facilities for training more than that number," and the hospital really cannot do its work properly unless it has more women and can only get them as nurses for training, what is to happen? That is a question which will crop up when the scheme comes into operation. I should like to hear from the Government how they think that that sort of question will be reconciled in practice.
The scheme of the Bill, as I understand it, is that each hospital will formulate its own estimates for expenditure on nurse training, it may be for the next year or for a period of years. After the formulation of those estimates, there will be discussion between the hospital and the nurse-training committee, and in due course the estimates will be approved. Each nurse-training committee, when it has its own completed set of estimates for the hospitals within its area, will no doubt compile a consolidated estimate which it will in turn have to discuss with the Council. In due course the Council will have a complete set of estimates for the country which will go to the Ministry of Health for approval. That is a reasonable enough procedure and it is one that is desirable.
After the approval of the estimates by the Minister of Health I should hope that there will be nothing in the nature of interference from above; in other words, that once the estimates are approved all that will remain to be done as between these various organisations will comprise general supervision on the part of the Council over the training of nurses and general supervision by the nurse-training committees over the hospitals within their areas. That seems to me to be a desirable set-up at which we should aim. I believe it is the set-up which the Government have in mind, although I believe it is not the set-up provided for in this Bill as now drafted.
I ask the Committee to look at the phraseology in this Clause, because I shall try to show that it would be impossible to work out a scheme on those lines in accordance with this phraseology. The part of the Clause which I wish to quote, stripped of the drafting phraseology, reads:


… expenditure by a Hospital Management Committee … being expenditure—

(a) for the purposes of … training … nurses; and
(b) of such description as the Minister may specify …;

shall, so far as it is incurred in accordance with estimates approved by the … nurse-training committee, … be defrayed by that committee.
The point to which I draw the attention of the Committee is that under subsection (1) of this Clause, which I have read, we are concerned only with expenditure which has already been specified by the Minister as expenditure which can properly be incurred for the purpose of training nurses. That is the effect of subsection (2).

12 noon

Mr. Blenkinsop: Perhaps I should explain that paragraph (b) does say "of such description." That is the general description of the type or category of expenditure rather than the precise detail.

Sir H. Lucas-Tooth: I appreciate what the Parliamentary Secretary has said, and I am grateful to him. I only wish he had said this on Second Reading, because we have been in very great difficulty. I asked him for an explanation then and he did not give one, with the result that we must thresh out the matter in Committee.
As I understand the interjection of the Parliamentary Secretary, it is that the Minister intends to give some general description of the kind of expenditure which may be approved by the training committees for the purpose of training nurses. At this stage I might ask him whether that is to be something in the nature of an instruction given privately—I do not mean without the knowledge of those concerned, but by circular letter or otherwise to individual training committees—or is it to be done by some general order which will come up for discussion in the House? I imagine that it will be a specification of a fairly general and wide kind.

Mr. Blenkinsop: It would be the intention to issue first of all a general indication of the categories of expenditure which my right hon. Friend would regard as coming within paragraph (b)—the types of expenditure that he would regard as coming within the nurse training fund.

It would be possible technically to separate it from the general administrative expenses of the hospital, because that is really the point. There are many expenses which may be regarded as connected with nurse training which it would be impracticable and unreasonable to separate from general administration expenses. Therefore, the purpose would be to set out in general terms the categories of expenditure which the Minister would regard as being separable and properly chargeable for this purpose. That would be the first step.

Sir H. Lucas-Tooth: I am obliged to the Parliamentary Secretary. Now we come to this point, that there will be some general indication given both to the nurse-training committees and to the hospitals as to the kind of expenditure which might be included in a scheme and might be included in payments to be defrayed through the training line of payment, if I may so call it. That must be available before any payments are submitted. It would be impossible to frame them without such information. After the information is given, there will be the question presumably of working out the estimates on the kind of lines indicated in my speech; so that there will be a second opportunity, so far as expenditure is concerned, for the estimates to be considered by the Ministry of Health. There is no question therefore of financial control. The financial control exists by the ordinary machinery of payment. The difficulty I have is in seeing why it is necessary to put in some provision for specially referring a question of expenditure under subsection (1) to the Minister.

Mr. Blenkinsop: Perhaps I can explain that now. A point might very well arise—this is merely where there is a difference of opinion which is to be—

The Deputy-Chairman: I think it would be better if the hon. Member for South Hendon (Sir H. Lucas-Tooth) moved his Amendment and then the Parliamentary Secretary replied, rather than that the Parliamentary Secretary should intervene now.

Sir H. Lucas-Tooth: I must apologise if I invited the Minister to join in a somewhat irregular Debate. The difficulty we are in is that we have not had previous information from the Government. I do not complain, because this is a difficult


matter with which to deal except in Committee. My objection to subsection (2) is that it contemplates the reference of two questions to the Minister which should have been resolved either by the general instruction given in advance of the payments or at the time of the formulation of the estimates. I cannot see why it should be necessary to have this special provision in the Clause as it stands.
Subsection (2) of this Clause appears to be in conflict with Section 7 of the Bill. Subsection (2) provides that any question arising with regard to expenditure shall be determined by the Minister, but Clause 7 of the Bill provides that any question arising between a nurse-training committee and a hospital relating, as the Bill is now drafted, to the exercise of the nurse-training committee's function under the Act:
shall, in default of agreement, be determined by the council.
It is true that subsection (2) of Clause 4 relates to questions of expenditure, whereas Clause 7 is entirely general; but I think that in the case of this sort of machinery there could be no question which does not involve expenditure, and obviously far and away the most important will be questions of expenditure. I consider that there is a serious conflict between these two parts of the Bill. It may be that there is something which I have overlooked, but I know there are doubts felt outside this House as to the way in which these questions will be dealt with. They obviously cannot be dealt with both by the Minister and the Council, and I should like to have an explanation from the Government of how they contemplate dealing with a mixed question involving policy of training and expenditure, having regard to the two different provisions of these two parts of the Bill.

Mr. Blenkinsop: I am grateful to the hon. Member for raising this matter. We would not wish that there should be any doubts about the operation of this Clause, and I am grateful for the opportunity to deal with it. It is essentially a matter which we can discuss most usefully in Committee.
As I mentioned earlier, it is the intention of my right hon. Friend first to issue general information as to the categories of expenditure that he would regard as coming within paragraph (b); not only,

of course, the sister tutors, expenditure on lecturers and others who would be required and general categories of expenditure of that kind, but it might very well include certain types of building, such as provision for classrooms, and so on. The hospital management committees and boards of governors, in framing their budgets for nurse training, would have regard to these specified types of expenditure which will be open to variation from time to time. Obviously there will need to be variation after experience of the work.
On submission of this budget from the hospital management committees and boards of governors, the new regional committees, which would of course have representatives of the boards of governors and the regional hospital boards, will consider those estimates. Possibly there may be some disagreement both on points of expenditure and on other matters of general policy, but it will be our hope that naturally we will get agreement in the regional committee that has been set up. We do not expect matters to be continuously sent up for final decision to the General Nursing Council or the Minister. The type of point which we have provided for here, upon which the Minister is to give a decision, is the case where we might assume that a hospital management committee has included in its training budget an expenditure which is within the general category of expenses laid down in the circular sent out by the Minister; for example, some new teaching centre, which, in view of the facts in the particular case, may also be used for many other purposes of general hospital administration.
It is for that reason that the regional committee might feel that it was not a matter that should be included in the training budget but one that ought to be included in the general administrative expenses of the hospital. That is the type of matter that would go to the Minister to decide—whether it should fall within training expenses or within the general hospital administrative expenses. For that reason, we feel that subsection (2) is necessary, because it does carry out a function additional to the other powers of the Minister.

Sir H. Lucas-Tooth: May I interrupt the hon. Gentleman? Where there is expenditure which is clearly partly train-


ing and partly administrative expenses of the hospital, does the Government contemplate that the Minister should be able to divide it up?

The Minister of Health (Mr. Aneurin Bevan): Yes. It is perfectly clear what is intended here. In this Bill, as a matter of fact, we are providing what is available already in the National Health Service. We are endeavouring to see to it that the academic side of medicine is kept entirely separate, and that the provision of apparatus on the secular side is the obligation of the Minister of Health. What has to be determined is where the expenditure should lie, and the Minister will decide it, while the General Nursing Council itself will decide matters relating to training.

Mr. Howard: The last words of the Minister are the most valuable and important, from my point of view, that I have so far heard in this Debate. I am regarding this purely as a rather difficult practical matter. There is no disagreement of any sort between any hon. Members of the Committee as to the importance of dividing, so far as they can be divided, the different functions of the employment of nurses and their training. We all welcome this Bill, and we hope it will be successful in achieving that difficult object, but there has been a good deal of difficulty in defining clearly the difference between the professional function of saying what is right and proper and the political function of determining how much money shall be made available for the carrying out of that purpose.
What the Parliamentary Secretary said frankly alarmed me, because he made it perfectly clear that the Minister was going to determine this question, and he made no reference in his reply to the fact—and, presumably, it is a fact—that, before making up his mind on a point of that character, he would consult the General Nursing Council. He never mentioned them, which shows, without being at all offensive, that there is a danger of the "administrative convenience" Departmental attitude creeping in. What the Minister said was quite a different thing. The General Nursing Council are the people who must decide what sort of functions apply or what sort of apparatus is in their view desirable for training.

Having decided it, no one disputes the right and necessity for the Minister preserving the position in which he can say "We cannot, unfortunately, provide the money for this, desirable as it may be."
12.15 p.m.
What I am anxious to get absolutely clear is that the authority which shall set out what is considered the best possible thing for nursing training shall be the General Nursing Council and not the Minister. I ask the Government to look at the Clause again, and to consider whether, between now and Report stage, they will not be able to make this point absolutely clear by an Amendment to subsection (1, b). The Minister has put down a new Amendment in the interpretation Clause dealing with the word "prescribed." It may seem irrelevant at the moment, though it is not, because the introduction of the word "prescribed" refers to the rules which may be made by the General Nursing Council and the way in which they are to be made. They have to be approved by the Minister and presented to Parliament, so that there is full control. I suggest to the Minister that he should consider altering subsection (1, b), and, instead of saying—
of such description as the Minister may specify
should say
of such description as may be prescribed.
That would mean that the General Nursing Council would have the responsibility placed upon them of laying down what they think should be specified, but that cannot possibly come into operation until the Minister has approved these rules, which would still be subject to being laid on the Table of the House. That may be too complicated, however, and the Minister might well use the very general term "specified"; but it is most important that we should know what it means.
I repeat that it is vitally important to get into the Bill both the fact that the determination of what is desirable from a professional point of view, and the question of what is best for the training of nurses, shall be a matter for the General Nursing Council to decide, and that what the Minister should do is decide how much money he can make available for the purpose. It should not be a Departmental responsibility to decide a matter


which should really be the responsibility of a proper professional authority.

Sir H. Lucas-Tooth: I listened carefully to what the Parliamentary Secretary said, and I certainly have no desire to press this Amendment, which in itself is not much more than a peg on which to hang the discussion. The Parliamentary Secretary has gone some way to clear our minds on this point, and, in seeking leave to withdraw this Amendment, I would say that we shall consider carefully what he has said, and, if necessary, put down Amendments at a later stage. We are grateful to him for his explanation, which has carried us some way. I hope the hon. Gentleman listened carefully to what was said by my hon. Friend the Member for Westminster, St. George's (Mr. Howard) and that he will give consideration to it before we reach another stage, in order to see whether it may be possible to put down further Amendments on the general lines which I have indicated. In those circumstances, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Motion made, and Question proposed, "That the Clause, as amended, stand part of the Bill."

Mr. Howard: I want to say one word on the Question "That the Clause stand part," which I did not wish to introduce into the discussion on the Amendment for fear of making a rather involved position even more involved. There has been some discussion on the part that teaching hospitals should or should not play in the standing nurse training committees, and I want to make it clear, as one closely associated with all the teaching hospitals, that so far as I am concerned as well as those with whom I am in close contact there is no desire whatsoever to isolate them from these proposed new committees.
Everyone concerned with the teaching hospitals must know that it is of vital importance to them that they should be in the closest possible touch with every person and body connected with medicine and the nursing world. Having said that, I would point out this one great difficulty—there will only be a certain amount of money available for this nurse training purpose. It will be doled out through the General Nursing Council to the regional standing nurse

training committees. That having happened there will be the inevitable danger of those regional committees trying to equalise the grants they have to make. It is a fact, of which I am sure the Minister and his Parliamentary Secretary will be aware, that there is bound to be a larger number of nursing staff in a hospital where there are medical students than in a hospital where there are none.
The trained nurses engaged there have not only the duty of looking after their patients and student nurses, but they have also some association with the medical students. Any medical man in the House would agree, so far as medical practice is concerned, that, as students, they learned as much in the approach to the patients from the ward sisters and trained nurses with whom they came in contact as they ever did from the most emminent of their professional colleagues. It is an indisputable fact that, if the work of the trained nurses in hospitals where there are under-graduate students in particular, and if the care of the patients and the supervision of the student nurses are to be carried out properly, there is bound to be a larger staff.
If we look up the figures in these circumstances it will be found that there is an apparent disproportion between the number of nursing personnel employed per ward, per bed, in a teaching hospital to the number in a non-teaching hospital. Before we pass from this Clause, I hope that the Minister or his Parliamentary Secretary will say in general terms that he recognises the truth of the facts which I have stated today, because that may help to get over a really great danger in the future, when there is not enough money available to satisfy everyone, of it being distributed on an equal basis instead of on the basis of making certain that necessary functions are carried out as far as possible.

Mr. Bevan: I could, without any difficulty at all, make a short statement about what the hon. Gentleman has just said. It would, of course, be quite silly for the hospital system as a whole to say that all hospitals, no matter where they are, no matter what kind of cases they are treating, would require the same number of skilled nurses. That is part of the difficulty of costing the hospital system. It would be quite easy if we could say that there were so many patients per bed,


and as a hospital has so many beds its ration of nurses amounted to so many. In that event the costing and control of the hospital administration would be as simple as selling pounds of margarine across the counter. We all know that is not the case. It is very difficult to find comparable hospitals. We shall, of course, confine it as much as possible so that costing systems are subject to identification and will show where gross extravagances take place. However, we have to have regard to what a particular hospital is doing, the kind of patient population that it has, what are the specialist needs of the hospital, and, of course, in this regard a teaching hospital occupies a peculiar position.

Mr. Howard: I am most grateful for what the Minister has said. He obviously sees the point I made, and he has dealt with it as fully as one could expect in present conditions.

Question put, and agreed to.

Clause, as amended, ordered 10 stand part of the Bill.

Clauses 5 and 6 ordered to stand part of the Bill.

Clause 7.—(REFERENCE OF DISPUTES TO THE COUNCIL.)

Amendments made: In page 4, line 40, after "or," insert:
between a standing nurse-training committee for a hospital area and.

In line 41, leave out "exercise," and insert "discharge."

In line 41, leave out "first-mentioned, and insert "standing nurse-training."—[Mr. Blenkinsop.]

Clause, as amended, ordered to stand part of the Bill.

Clause 8.—(THE FINANCE COMMITTEE.)

Sir H. Lucas-Tooth: I beg to move, in page 5, line 3, after the first "of," to insert:
not less than seven nor more than eleven.
This Amendment has been put down in order to obtain from the Government some indication of what their intentions are regarding the numbers on the proposed finance committees. We have left a fairly wide margin, and we have kept the numbers fairly low. On this side of the Committee we feel that a finance com- 
mittee should not be a very large and unwieldly body, though, of course, it must be large enough to include those who will be required to deal with the extremely complex functions which have to be performed by the committee because of their duties under this Clause. I think it is unnecessary to detain the Committee by enlarging on the subject, but if we could get some indication from the Government of what they intend in this connection it will be of value to those of us who are interested in the matter.

12.30 p.m.

Mr. Blenkinsop: It is our general feeling that we do not want in any way to limit or unduly restrict the powers of the General Nursing Council in setting up this committee. I think it is commonly agreed that no one wishes to do that. We would all agree that it would be normally desirable that a finance committee should not be a large body, but I think we would be putting ourselves in some difficulty and taking a responsibility which we would rather leave to the General Nursing Council if we were to specify, even within the limits suggested in this Amendment, any kind of precise numbers for the finance committee. I believe the general view of the Committee is that it is normally desirable for the finance committee to be a reasonably small body, but I am sure that this is a matter which we ought to leave to the General Nursing Council itself to decide.
Perhaps I might refer to some of the other general points that are raised by other Amendments on the Order Paper which are obviously connected with this one. It is again our feeling that although we have sympathy with the object of some of the proposals in these Amendments. and although we are most anxious that the finance committee should be a committee of real standing, at the same time we want to make sure that the final responsibility is in the hands of the General Nursing Council and that the finance committee should not in any way be regarded as a body wholly independent of the General Nursing Council. It is, therefore, very important that while we consider what we can do to ensure that the finance committee is a responsible body fully able to deal with the important matters which will be referred to it, at the same time we must still realise that it is a committee of the


General Nursing Council and that the final responsibility must be in the hands of the General Nursing Council itself.
Therefore, I do not want to do anything that would detract from the responsibility of the main body, while appreciating to the full the point made by hon. Members opposite who wish to ensure that the finance committee will itself be a body of real standing. I do not feel that we can accept this Amendment, but on the general point that has been raised I am willing to have a further look at the wording to see whether we can reconcile the two points of view—whether we can maintain the final authority of the General Nursing Council and at the same time ensure that the finance committee will be a body of real standing and importance.

Mr. Skinnard: rose—

Sir H. Lucas-Tooth: On a point of Order, Mr. Bowles. The discussion has gone rather wider than the scope of the Amendment which I moved. My hon. Friend the Member for Putney (Mr. Linstead) has an Amendment on the Order Paper which he is anxious to move, and the same point can adequately be raised on that Amendment. In view of what the Parliamentary Secretary has said, it might be convenient if I withdrew this Amendment so that my hon. Friend should move his Amendment, the terms of which are a good deal wider, and the discussion might take place more appropriately on that Amendment. I therefore beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Linstead: I beg to move, in page 5, line 3, at the end, to insert:
which shall include the three members appointed by the Minister as appearing to him to have had experience of the control and management of hospitals.
The point of this Amendment is, as has been said, wider than that which we have just been discussing. I gather than while the Parliamentary Secretary has not finally closed the door, the view he takes at present is that the Bill should stand more or less as it has come to us from another place in respect of this Clause. I am sorry that he should have come to that conclusion. I am not speaking entirely on a theoretical basis; I have had many years'

experience of the relationship between a body prescribing standards and the training institutions in which those standards have to be reached.
I am certain that it is bad administration to bring into the hands of the same body the prescribing of standards and the prescribing of the ways and means by which those standards are achieved, because I am sure they are essentially two different functions. The body prescribing the standards ought to be engaged in a tug-of-war with the body providing the finance. I am certain that there is all the difference in the world between a General Nursing Council whose primary duty is to say what standards shall be laid down in the interests of the profession and the public, and a General Nursing Council which meets to decide how they shall distribute the money which is at their disposal. There are two different mental approaches to the problem according to which of those two functions one performs.
It was with pleasure that a few minutes ago I heard the Minister say that all the way through this service we have never had a need to separate the academic side of professional work from the provision of what he called the physical apparatus. That is the principle which I want to establish—that the body which provides the standards shall not provide the apparatus for carrying them out. I am surprised to find that we still have in the Bill, and apparently acceptable to the Ministry, provisions which seem to conflict with what the Minister, I thought quite properly, said to us just now.
I ask the Committee to look at the prescribed functions of the General Nursing Council in the 1919 Act. Among other functions that Council has the duty of making rules
regulating the conditions of admission to the register; for regulating the conduct of any examinations … and any matters ancillary to or connected with any such examinations.
I suppose that includes courses of training. Then disciplinary rules can be made prescribing the conditions under which nurses may be removed from the register. The General Nursing Council is constituted with not merely one eye on those functions but with both eyes on them. It was for that purpose that the constitution of the General Nursing Council was determined as it is.
By the accident of Parliamentary machinery a new function has been put upon the General Nursing Council by the decision taken in another place, and that is the function of distributing grants. That not only conflicts, for the reason which I have stated, with the duty of prescribing standards, but it also brings into question the suitability of the General Nursing Council, as constituted for its first purpose, to carry out adequately its second purpose. It is for that reason that I put down the Amendment, which was not called, in page 5, line 2, to leave out "consisting of members of the Council," and to insert
which shall include, in addition to members of the Council, persons experienced in the administration of grants to educational institutions.
That Amendment seeks to add additional people to the Council in order to give it a better balance for its new purpose. It is for the same reason that my hon. Friend has put down the Amendment which we are now discussing. If we have to accept the situation which the Parliamentary Secretary has presented to us this morning, namely, that the General Nursing Council is to have the power to prescribe standards and also to distribute the money by which those standards can be reached, there must be a very substantial element of delegation within the machinery of the General Nursing Council. I think it is a mistake to bring them under the same umbrella, but if both—

Mr. Blenkinsop: The hon. Member will realise that in one case it is merely a matter of distributing money. The money made available for training, unlike the professional requirements of the General Nursing Council, will come from the Government in future, but the professional fees, the sums required purely on the professional side, will come out of the Council's own finance.

Mr. Linstead: The Parliamentary Secretary is now saying that the expenses incurred under Clause 6, that is:
All expenses incurred by a standing nurse-training committee with the approval of the Council shall be defrayed by the Council,
are not the same expenses as those referred to in Clause 4, namely,

estimates approved by the standing nurse-training committee shall be defrayed by that committee.
Is the Parliamentary Secretary now saying that the expenditure which they defray under Clause 4 is not the same thing as the expenses under Clause 6?

The Deputy-Chairman (Mr. Bowles): Might I suggest to the hon. Member that he should complete the moving of his Amendment rather than invite the Government to reply at this stage. There is no Question before the Committee?

Mr. Linstead: I wanted to deal with the most helpful interruption of the Parliamentary Secretary, because I am not at all sure that it does not take a great deal away from my Amendment, but in order to give the Parliamentary Secretary an opportunity to reply at slightly greater length, I will conclude.

Mr. Diamond: This discussion has gone to the root of certain matters covered both by this Clause and by other Clauses. It is rather difficult to pick up all these matters at the same time. May I say that I appreciate the spirit behind this Amendment? I am not sure that there is any difference of opinion as to the views of the hon. Member for Putney (Mr. Linstead) has put forward, that there seems to be a reasonable distinction between these two functions, and that where there is a clash the same person should not have the responsibility of answering in two different capacities—no one can do that successfully. But it seems to me that that is not the position under the Clause.
12.45 p.m.
It is true, of course, that the two functions will go together, and it is only at a certain point that these differences to which the hon. Member has referred may arise. If these functions are vested in two different persons sitting down at a table together, I am sure the hon. Member will agree that, as far as possible it will be beneficial if they can see eye to eye with each other and co-operate as far as their respective points of view are capable of being satisfied. It is only when we come to the stage where these points of view differ that provision should be made for different persons answering the two different questions, which is exactly what we have under the Bill. We have the General Nursing Council giving the


answer on certain questions, and the Minister, with the General Nursing Council, giving answers to certain other questions where disputes arise. In these circumstances, I think the Bill has been satisfactorily drawn up.
In regard to the more limited point about the three members appointed by the Minister and other matters the hon. Member has discussed in relation to it, I can only support what my hon. Friend has said, that this Committee, however strong it may be, must be a committee of the General Nursing Council. In this connection, it is of interest that the present finance committee of the General Nursing Council consists of eight persons, which is somewhat more than seven and somewhat less than 11. I have no doubt it will automatically follow that members of the General Nursing Council with special ability in this connection will find themselves on the finance committee. I hope, therefore, that it will be possible for us to agree with the Parliamentary Secretary that the General Nursing Council should not be any more than it is at present. I hope that this Amendment will not be carried any further than is absolutely necessary.

Mr. Blenkinsop: I am very anxious that we should be clear on this. I subscribe entirely to what my hon. Friend the Member for Blackley (Mr. Diamond) has just said. We naturally expect that these three persons who have been appointed to the General Nursing Council, for the reason that they have experience of the control and management of hospitals, will most probably be the people appointed to the finance committee, but we do not wish to tie down the General Nursing Council completely to the appointment of these three people, which would be a little unreasonable. We have every confidence in the General Nursing Council, but it may be that among these three persons there is one who is not as suitable for working on the finance committee as the others. We must leave this reasonable amount of latitude to the General Nursing Council.
Expenditure under Clause 6 is the same as under Clause 4, but there is also expenditure provided for in Clause 19. It is true that the standing nurse-training committees will be responsible for the general training expenses, which will be submitted through the budgets coming

down from the hospital management committees and the boards of governors. The peculiar expenses of the General Nursing Council of a professional character will remain their own responsibility, and they will be met out of the contributions and fees of their members. There is that clear division between the two. I accept the principle, which is an important principle, that there should be as much division as we can administratively provide between the actual training and the responsibility for standards. I think we have got as near to it as we can within a framework that is workable.
Attempts were made in another place to make certain changes which it was finally agreed would not operate successfully, and general satisfaction was expressed with the Amendments we were able to make, including the setting up of this finance committee in the terms as they now appear on the Notice Paper. I assure the hon. Member that we are very conscious of the point he has raised. If there is any further clarification we can make in Clause 8, without interfering with the final responsibility of the General Nursing Council itself, then we are quite prepared to look at it.

Mr. Howard: We are in complete agreement as to what we want to achieve, but we are not in complete agreement yet as to whether we have achieved the best possible result or not. I want to make this one suggestion. Will the Parliamentary Secretary turn over in his mind between now and the Report Stage the possibility which, without being egotistical, I would remind him that I mentioned on Second Reading, that it might go some way to solve this problem if, as well as having a statutory finance committee of the G.N.C., its education or training committee were also given statutory position. I am not certain whether it is called an educational or training committee. Then we should, perhaps, secure a better balance. There are probably objections to it, but I throw it out as a possibility which I think is worthy of serious consideration between now and the Report stage.

Mr. Linstead: I have, unfortunately, committed myself to, an engagement which makes it necessary for me to leave the Committee shortly, and I hope that the Parliamentary Secretary and the Committee will accept my apologies. I am


grateful to the Parliamentary Secretary for what he said, but I feel again that I am on firm ground. I thought for the moment there was a differentiation between two forms of expenditure. It is clear to me now that there is not, and that, in fact, the General Nursing Council is being asked to do the very thing the hon. Member for Blackley (Mr. Diamond) said they should not be asked to do. In his own words, "One and the same person has power to answer two different questions." I am sure that, as experience accumulates, it will be found that that is a mistake.
After all, this new arrangement is not an intrinsic part of the structure of the Bill. It is something which got grafted on to the Bill, and I am sure that enough consideration has not been given to all the implications that follow from making the general standard prescribing body a general granting body, which, in fact, is what this does. I hope very much that the suggestion thrown out by my hon. Friend the Member for Westminster, St. George's (Mr. Howard) will be considered even in the short time we have between now and Report, because I am certain there is something fundamentally weak in the structure of the General Nursing Council as we are leaving it. I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.

Clauses 9 to 11 ordered to stand part of the Bill.

Clause 12.—(PROVISIONS RELATING TO THE APPROVAL OF TRAINING INSTITUTIONS.)

Mr. Blenkinsop: I beg to move, in page 8, line 31, at the end, to insert:
(3) The Lord Chancellor may pay to any person nominated by him under the last foregoing subsection such fees and allowances as the Lord Chancellor may, with the consent of the Treasury, determine; and any expenses incurred by the Lord Chancellor under this subsection shall be defrayed out of moneys provided by Parliament.
This Amendment reinserts in the Bill words proposed in another place, which constitute a matter of Privilege.

Amendment agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 13.—(FEES AND CONTRIBUTIONS IN RESPECT OF TRAINING INSTITUTIONS.)

Mr. Blenkinsop: I beg to move, in page 9, line 3, at the end, to add:
(2) The Minister may make to the Council, out of moneys provided by Parliament, contributions of such amounts as he may determine towards the expenses of the Council in inspecting and approving for the purposes of the training rules institutions vested in him.
This Amendment is made here, like the last, for reasons of Privilege.

Mr. Diamond: I support the Amendment, having regard to the very firm assurance which my hon. Friend gave me when this matter was discussed on the Committee stage of the Financial Resolution, which, for the purpose of accuracy, I have in front of me, and will quote:
I would add the assurance that it is the intention to ensure that 100 per cent. reimbursement of all expenses approved by the Minister … will be guaranteed under this wording."—[OFFICIAL REPORT, 21st October, 1949; Vol. 468, cols. 965–6.]
In view of that assurance, which, I am sure, could not have been improved on in any circumstances, I am very happy to support the introduction of this subsection.

Amendment agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 14 ordered to stand part of the Bill.

Clause 15.—(REGISTRATION, ETC., FEES.)

Amendment made: In page 10, line 4, after "in," insert "relation to."—[Mr. Blenkinsop.]

Clause, as amended, ordered to stand part of the Bill.

Clause 16.—(INFORMATION WITH RESPECT TO NURSES.)

Amendments made: In page 10, line 15, leave out "and," and insert "or."

In line 16, leave out "and," and insert 44 or."

In line 16, leave out "respectively."—[Mr. Blenkinsop.]

Clause, as amended, ordered to stand part of the Bill.

Clauses 17 and 18 ordered to stand part of the Bill.

Clause 19.—(EXPENSES OF THE COUNCIL.)

Mr. Blenkinsop: I beg to move, in page 11, line 8, at the beginning, to insert:
All expenses incurred by the Council with the approval of the Minister which are attributable to defraying expenditure incurred by standing nurse-training committees shall be defrayed by the Minister out of moneys provided by Parliament, and.

This is another privileged Amendment.

Amendment agreed to.

Mr. Blenkinsop: I beg to move, in page 11, line 14, to leave out from "defrayed," to the end of line 15, and to add "by the Council."
The powers given to the Council by paragraph 8 of the First Schedule in relation to disposal of property, and their spending powers over proceeds of fees and contributions, seem to us too narrow. They should, for example, in certain cases, have power to spend money arising from disposal of property—a power which they do not at the moment possess. In normal circumstances one would desire the Council to be able to meet current expenditure out of current income, but there may be good reason why from time to time they should have, at least, power to spend money arising in these ways.

Mr. Diamond: I appreciate the action of the Parliamentary Secretary in removing words, and so automatically removing the restriction upon the financial action of the Council, but I have the fear that from the removal of these words misunderstanding may arise. I fear that the removal of these words may be interpreted as an invitation to anyone who so desires to put pressure on the Council to do other than meet its current expenditure out of current income. I am sure, especially having regard to the remark which the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) was so incautious as to make on Second Reading of the Bill with regard to the finance of the Council, that it would be the wish of all sides of the Committee that this Council should carry on its financial affairs as any other well appointed body, on the basis of meeting its expenses, as far as humanly possible, out of current income. If there appear to be good reasons why it could not, over a couple of years, say, meet its expenses, then it

ought to consider varying its main income. Here we have what may be interpreted as an open invitation to the Council to mortgage its substantial property, and out of its capital accumulated in the past—I do not know exactly how it has been accumulated, but at all events it is there—to meet ordinary outgoings. That, I am sure, would be a very bad thing.
1.0 p.m.
In order to appreciate the size of this problem I have looked at the figures, and I think the Committee would be interested to know that the Council has at present some £120,000 worth of property. The Chancellor of the Exchequer is already aware of that. That is, of course, capital. On its accumulated income and expenditure, however, it has a minus figure of some £10,000, so that the net figure is about £110,000. In short, this Council has no funds other than current income, out of which to meet current expenditure, unless it were to eat into the capital so accumulated—which it may have to do, but which it would only wish to do as a last resort. I therefore hope that my hon. Friend will make it clear that in proposing the deletion of these words he is merely wishing to extend the financial freedom of the Council, and is not by any means inviting the Council at any time to do other than conduct its finances in the most proper fashion.

Sir H. Lucas-Tooth: I must confess that I am really shocked by this Amendment. The Government are quite blatantly empowering the Council to live on capital. There is no question about that. I do not want to strike a discordant note, and I do not think this is a matter we would wish to press so far as a Division, but this is an Amendment which we on this side of the Committee cannot welcome. I can see no reason whatever why the Council should be empowered to spend capital other than for income purposes. That, I think, is the only effect of this Amendment.
The Parliamentary Secretary said that this might be a power which it would be desirable to exercise in certain circumstances. Well, that is a little vague. The House ought to be told what kind of circumstances he contemplates. After all, any charitable concern is very strictly controlled by the law; no charity can expend a capital sum for income purposes


without either a special Act of Parliament or the sanction of the courts. This is a power we should give very grudgingly, and if we let this Amendment go without strongly protesting the Government must understand that it is in no way a precedent, and that we do so only because we think this is not a Bill on which we should raise needless contentions.

Question, "That the words proposed to be left out stand part of the Clause," put, and negatived.

Question proposed, "That those words be there inserted."

Mr. Diamond: On a point of Order. Before the Committee agrees to the insertion of the words "by the Council," would it be in Order for me to speak on the possibility of adding certain alternative words?

The Deputy-Chairman (Mr. Bowles): I have considered this matter, and I thought that the next Amendment, standing in the name of the hon. Gentleman—in line 14 to leave out from "defrayed" to the end of line 15, and to add:
by them out of sums received by them by way of fees and contributions"—
was covered by the Government Amendment. It was therefore my intention not to select it. The hon. Gentleman can certainly speak on this Question, but he cannot now move an Amendment.

Mr. Diamond: I appreciate that. I am grateful to you, Mr. Bowles, and I apologise for detaining the Committee yet a second time on this Amendment. On the first occasion on which I spoke I did not, of course, deal with what I thought would be a preferable form of wording to the form put down by my right hon. Friend in this composite Amendment. It is proposed to add simply the words "by the Council," whereas it is clear that there might be another form of words which could conceivably have reference to sums received by the Council by way of fees and contributions, which form of wording might be better than that which my hon. Friend has put before the Committee.
Perhaps in this connection I might refer to the form of wording used in the 1919 Act, which refers to defraying
out of the sums received by the Council by way of fees.

I, as an accountant, would understand that to mean that where fees received in any particular year are not expended in ordinary current expenditure for that year, then at a subsequent period the unexpended balance would be described as "sums received by way of fees," and it would be open to the Council to spend that money, because the money would not be fees but would be coming out of sums received earlier by way of fees. Those words, of course, do not refer to any Amendment which you, Mr. Bowles, have not selected. I am referring to the words used in the 1919 Act.

The Deputy-Chairman: I have allowed the hon. Gentleman to make a speech on this question, on the understanding that he is not trying to move an Amendment in the course of it. The Government will, of course, take notice of what he is saying, and if they are influenced by it will no doubt make the necessary arrangements later on. The hon. Gentleman can certainly refer to the words which he wants to have inserted.

Mr. Diamond: I am most grateful to you, Mr. Bowles. It will be helpful if, instead of the words proposed by my hon. Friend in this Amendment, there were substituted the words:
by them out of sums received by them by way of fees and contributions.
That would have the effect of altering the emphasis, which is all I seek to do. It would be within the power of the Council in an emergency to apply capital funds for ordinary current purposes, but the Council would not be invited to go on in a reckless extravagant way, using capital for current expenditure, as might be misunderstood by the mere deletion of these words to which the Committee has agreed.

Mr. Blenkinsop: I do not want it to go out from this Committee that we want in any way to encourage the General Nursing Council to embark upon some form of profligacy. It was our intention, and still is, that the Council should not be prevented—as it is our view that they are at the moment—from applying, for example, rents or interest to defraying their expenses. Indeed, we are giving power for them to mortgage their property, and there is not much sense in their having power to mortgage if they have not the power in an emergency to use the funds they receive from it. I


appreciate the general point that has been raised, but I do not think there is anything between us. At the moment we are not satisfied that the words suggested in my hon. Friend's Amendment, which has not been selected, really meet the case adequately; we are not satisfied that they do give the power in an emergency which my hon. Friend himself would desire that they should possess.

Question put, and agreed to.

Clause 19, as amended, ordered to stand part of the Bill.

Clause 20 ordered to stand part of the Bill.

Clause 21.—(INTERPRETATION.)

Mr. Blenkinsop: I beg to move, in page 11, line 35, at the end, to insert:
'chief male nurse' means a male nurse in charge of the male nurses employed in a mental hospital.
There is a later Amendment to the Third Schedule, in page 17, line 9, which introduces the term "chief male nurse," which accordingly has to be defined here.

Amendment agreed to.

Mr. Blenkinsop: I beg to move, in page 12, line 8, at the end, to insert:
'prescribed' means prescribed by rules made by the Council under this Act.
This is a drafting Amendment.

Mr. Howard: I would ask whether this is really and necessarily a drafting Amendment. Acts of Parliament are already sufficiently complicated, but the need for the Amendment appears to arise from the fact that the word "prescribed" is used in the Bill. That word has not been used in the previous Acts of Parliament dealing with nurses. Provision is made under which the General Nursing Council may make rules. It is set out how they have to make the rules and the procedure to be followed. As far as I can see, the need for this additional complication arises merely because in Clause 18 the word "prescribed" has been introduced.
This is a detail and a technical point, but I ask the Parliamentary Secretary to have it looked into in the Department between now and the Report stage. I am sure that he will agree with me that if we can exclude anything that complicates the law it is the general desire that we should do so.

Mr. Blenkinsop: I am very ready to have a look at the matter.

Amendment agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 22 ordered to stand part of the Bill.

New Clause.—(MEMBERSHIP OF THE COUNCIL, ETC., NOT TO INVOLVE PARLIAMENTARY DISQUALIFICATION.)

A member of the Council, the Assistant Nurses Committee, the Mental Nurses Committee, a standing nurse-training committee or a sub-committee of a standing nurse-training committee shall not, by reason of his membership, be rendered incapable of being elected, or of sitting and voting, as a member of the House of Commons.—[Mr. Blenkinsop.]

Brought up, and read the First time.

Mr. Blenkinsop: I beg to move, "That the Clause be read a Second time."
The object of the Clause is to make it clear that membership of the Council will not involve parliamentary disqualification. The position has not arisen up to now, I am glad to say, because the General Nursing Council have only had power to defray certain limited expenses. Now they are being given rather wider power to reimburse for loss of income from employment. That is regarded as possibly endangering the position with reference to parliamentary disqualification.

Question put, and agreed to.

Clause read a Second time, and added to the Bill.

New Clause.—(AMENDMENT OF SECTION EIGHTEEN OF ACT OF 1943.)

Subsection (3) of section eighteen of the Act of 1943 shall be read and construed as if after the words "Any person who" there were inserted the following paragraph:—
(a) not being a person whose name is included in any part of the list, says or does anything implying that his name is included in some part thereof; or."—[Mr. Diamond.]

Brought up, and read the First time.

Mr. Diamond: I beg to move, "That the Clause be read a Second time."
The purpose of the proposed new Clause is to fill a gap which was left erroneously, I feel sure, in the earlier Act. Under that Act it was possible for the Council to take proceedings against


those falsely claiming to be covered by the Act but, as it subsequently transpired, it was not possible for the Council to take proceedings in the limited case covered by the Amendment, that of a person whose name is not included in any part of the list saying or doing anything which implies that his name is so included. If a person was included in some part of the list, and said falsely that he or she was in another part of the list, it was possible for the Council to take proceedings against that person, quite properly, to protect the status of assistant nurses. If the person's name was not included in any part of the list, no proceedings, it was found, could be taken against that person for falsely claiming to be on the list.
I am sure that we do not want at this late stage to appear to be introducing legislation which creates new penalties under an Act of 1943. Nevertheless, a case does exist in which the Council had the wish to prosecute a person falsely claiming to be on the list. The Council were advised by their legal advisers that it was not possible to do so under the Act as it existed. For those reasons the proposed new Clause has been framed.

1.15 p.m.

Mr. Blenkinsop: In moving the proposed new Clause my hon. Friend has mentioned the reason why we would not be very willing to include the Clause ourselves. It is true that one instance has occurred, but I think he would be the first to agree that it is a pity to legislate for the exceptional circumstance. Furthermore, the list is gradually being superseded. It is already closed to new entrants and opportunity is being given under the Bill for those who are on the list to move on to the register. Gradually the list will decline in importance.
Therefore, I should have thought it was undesirable, unless there were some overpowering reasons, to include new powers to deal with the matter of this single instance of which we have information, and which I believe can possibly be dealt with in another way. That matter has been looked at by our legal advisers and I am assured that it is possible to deal with that type of case in another way than by inserting the proposed new Clause. For those reasons I

hope that my hon. Friend will withdraw the Motion.

Mr. Diamond: There is a great responsibility on the Council for protecting the status of all the nurses for whom it is responsible. Although I am very glad to hear my hon. Friend say that there is possibly—I do not think he went very much further than that—a way of dealing with this matter, I would ask him to bear in mind that I have sinned greatly in bringing this matter before the Committee. If there were only one case and I had said nothing about it, nobody would be any the wiser. Having brought it erroneously to the full light of day in the Committee, it is now open and public knowledge that the armament of the General Nursing Council for protecting its nurses of various categories is not entirely bullet proof. The position might not have been very serious—having regard to the fact that only one case has arisen—before anybody knew about it outside the Council. Now I have, at the Council's request, put this matter forward.
I therefore think that the matter should be given rather more careful thought than would have been necessary earlier. I hope that the Minister will now give this matter very careful consideration and will either find means which are satisfactory to the legal advisers of the Council to enable them to discharge the responsibilities put upon them by this House in an earlier Act, or will introduce words at a later stage enabling him to do so. In that very confident expectation I beg to ask leave to withdraw the Motion.

Motion, and Clause, by leave withdrawn.

First Schedule.—(THE GENERAL NURSING COUNCIL FOR ENGLAND AND WALES.)

Mr. Howard: I beg to move, in page 13, line 11, at the end, to insert:
and one shall be a member of the University Grants Committee.
The Amendment needs very few words of explanation because it particularises a general picture which we have discussed more than once already this morning. It is an attempt to make the good even better. The Bill provides that the Council shall include
two persons … of whom one shall be appointed to represent universities in England and Wales.


The Amendment seeks to provide that one of those two persons shall be a member of the University Grants Committee, in order to ensure that amongst those two members appointed by the Privy Council there shall be one with the highest possible experience of work parallel to that which the General Nursing Council, as reconstituted, will have to do.

Mr. Blenkinsop: I do not feel that we should tie the hands of the Privy Council in this way. They already have the obligation that one of the two members appointed by them shall represent the universities in England and Wales. It seems to me that if we were to make a specific requirement in the manner which is suggested, they would be prevented from exercising any general discretion at all. There is also the point that it might happen that they would not be able to get the agreement of a member of the University Grants Committee to serve as suggested. In that event they would be placed in a rather difficult position. On all these suggestions of further specification of particular categories for representation, we have already gone as far as we ought to go. We have given the matter a very great deal of consideration and there is danger in tying the hands of the appointing bodies too tightly.

Mr. Howard: There is great force in the answer which has been given by the Parliamentary Secretary. I am sure he will not disregard the point of view expressed in the Amendment, but in view of what he has said I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Blenkinsop: I beg to move, in page 13, line 16, after "persons," to insert:
(hereinafter referred to as 'the general electors').

This is a drafting Amendment.

Amendment agreed to.

Further Amendment made: In line 20, leave out from "children," to end of line 21, and insert:
(whether or not they are also registered in either or both of those parts)."—[Mr. Blenkinsop.]

Mr. Blenkinsop: I beg to move, in page 13, line 37, to leave out "by local health authorities," and to insert

in services provided under Part III of the National Health Service Act, 1946.
Some of the local health authority services under Part III of the National Health Service Act may be provided by voluntary organisations as agents of the local authority. We have no wish to exclude possible representation of that kind of service and the Amendment ensures that there may be a selection from the voluntary services as well as from the local authority.

Sir H. Lucas-Tooth: I should like to say how much we on this side of the Committee welcome the Amendment, which we regard as being wholly in the right direction.

Amendment agreed to.

Mr. Burden: I beg to move, in page 14, line 6, at the end, to insert:
(d) one shall be a nurse whose name is included in the supplementary part of the register containing the names of nurses trained in the nursing of persons suffering from infectious diseases, appointed by him after consultation with such persons and bodies as he thinks fit, being persons and bodies having special knowledge and experience of the work of nurses whose names are so included.
The Amendment has the support of the National Association of Local Government Officers and emanates from the membership within their ranks. Secondly, I submit that the nursing staff in question are in possession of special qualifications. Direct representation on the General Nursing Council would enable this very important section of the nursing staffs to make a distinctive and real contribution to the work of the Council. That contribution, I believe, can only be made by someone with a personal and intimate knowledge of the problems affecting this section of the nursing staffs.
I cannot see why the particular Section of the nursing service embraced by the Amendment should be treated differently from the nurses in Scotland. I know that Emerson says that
A foolish consistency is the hobgoblin of little minds
but the First Schedule to the Nurses (Scotland) Bill uses these words:
one, who shall be a registered fever nurse, shall be elected by registered fever nurses.
The registered fever nurses in England cannot understand why the Minister treats


them differently from their colleagues in Scotland and why there is to be a different set-up for the General Nursing Council in England to that in Scotland.

Mr. Blenkinsop: I am in some doubt about this whole series of Amendments. If we were to grant what is asked for, we would have to increase the size of the General Nursing Council rather considerably. [HON. MEMBERS: "No."] If they were all to be added together, that is true. Obviously, it is important that instead of having an unwieldy General Nursing Council—it might be argued that we already have a body which is somewhat too large—we ought to try to retain, as I mentioned in replying to the previous Amendment, in the hands of the appointing Ministers and the Privy Council some discretion regarding the interests of the persons to be represented If I were to give way on this series of Amendments we would lose that freedom which it is vital for the Minister to retain.
Naturally the Minister, in deciding upon the three places which are open to him to appoint, would have regard to this class of nurses amongst others; but it would be wrong to tie the Minister to these particularisations. Furthermore, I am glad to be able to say that, owing to the decline of the need for fever nurses, at which we are all delighted, the fever register is declining rapidly. New admissions, I understand, have declined from 740 in 1946 to about 300 this year. Indeed, we would rather look forward to the early cessation of special training for this register, and we would rather expect to find within the general training of nurses that knowledge of infectious diseases that is necessary and which would give them, within the representation already provided for the nurses, the type of experience which has been referred to.
The position in Scotland is rather different. We should not necessarily follow Scottish practice in every case, because their definition of a fever nurse includes rather different types of nurses from ours. For that reason, I trust that my hon. Friend will not press the Amendment.

1.30 p.m.

Mr. Burden: Would the Minister, in making these appointments, consider

what I have submitted to the Committee, and would it be understood that he will endeavour to consult bodies with special knowledge of the range of problems before the appointments are made?

Amendment negatived.

Mr. Skinnard: I beg to move, in page 14, line 7, to leave out, "one." and to insert "two."
I may have been foolishly optimistic but I had anticipated being able to avoid repeating this morning some of the arguments I used in my Second Reading speech last week, arguments which were supported by several of my hon. Friends who subsequently put their names to this Amendment. The Minister has not hedged and I am grateful to my hon. Friend the Member for the Park Division of Sheffield (Mr. Burden) for having drawn his fire so that I had some forewarning of the treatment which this Amendment and its consequential Amendments would be likely to receive.
That leads me to remind the Minister that he himself has decided the case on numerical grounds, for this is one of the Amendments which he took in a body, as limiting further his power of appointment. One of the Amendments to come is rash enough to ask for two out of the three places of his limited free choice, so I anticipate that it will get short shrift. Therefore, my humble request for just one only out of the three free places he has at the moment will, I am sure, receive greater favour than he was prepared to give a moment ago.
I would remind the Committee that while it is true that the 14 regions will each be called upon to elect a member of the nursing profession, it is more than likely that the majority of those, if not the entire number, will for reasons of prestige and their greater opportunities of appealing to the electorate be matrons of hospitals, probably senior matrons—that is, matrons senior in the nursing profession. Ward sisters—the necessity for the inclusion of a representative of which class is acknowledged by the provision I seek to have amended, are busy hospital executives with a varied range of duties and have not at their disposal the facilities which matrons have for putting out, as it were, an election address; for getting letters despatched to what will be quite considerable regional


constituencies. I hesitate to say this because I know some startling exceptions to the rule, but ward sisters generally are apt to be modest in their estimate of their own importance in the nursing world, however vigorous they may be within the confines of their on hospital. They do not know what administrative and legislative possibilities in their profession are opening up for them in many cases.
I am not asking for an undue representation. I am only asking that ward sisters may make their point of view heard in the committee. The Minister will not be able to deny the likelihood that the only ward sister on the General Nursing Council will be the one he will have to appoint on the original provision. And the Minister himself, in trying to stave off my hon. Friend the Member for the Park Division of Sheffield, gave me this weapon. I would remind him that he himself said that the General Nursing Council may be deemed to be a little unwieldy already. How much more difficult then will be the task of the solitary representative of the technical nursing side of our hospital work if she is alone in a Council of that size. All I am asking, therefore, is that any proposal that the ward sisters, acting for the majority of hospital nurses, wish to put forward shall be assured of free consideration and an adequate discussion because there will be at least a proposer and a seconder for their point of view on the Council.

Mr. Sorensen: I support strongly the plea made by my hon. Friend the Member for East Harrow (Mr. Skinnard) and I was sorry that the Parliamentary Secretary seemed rather scornfully to throw all these Amendments into the wastepaper basket—

Hon. Members: No.

Mr. Skinnard: Like the late Mrs. Gamp, he sought to "proticipate."

Mr. Sorensen: If he did not do so, I withdraw part of that. Shall I say he was rather disdainful? [HON. MEMBERS: "No."] Then I withdraw it altogether and will assume instead that my hon. Friend was most anxious to try to meet our plea, but that he foresaw some insuperable difficulties, one of which was that he thought this was over-particu- 
larising the kind of representative who should be on the Council. Yet already he has accepted the principle of particularisation.
We have just accepted an Amendment to line 37 of this Schedule to the effect that two shall be registered nurses in services provided under Part III of the National Health Service Act, 1946. If the Parliamentary Secretary is prepared to particularise in that case, surely it is much more necessary to particularise in regard to ward sisters who are the backbone of the profession and have more continuous experience of actual nursing? It was for that reason that I used the unfortunate words I did, and although I have withdrawn them, the Parliamentary Secretary must realise that he cannot have it both ways. The fear he has expressed of over-particularisation falls to the ground, and therefore I urge him to accept the Amendment.
It may very well be that we would have a nurses' council on which no working nurse appeared. Although matrons and others well versed in administration would be there, it might be that none of the working nurses would be appointed I must urgently appeal to the Parliamentary Secretary to consider this very sympathetically. As any of us who has experience of hospitals knows, it is the ward sister who is the pivot around which the whole system revolves. We have to try to get as many working nurses and ward sisters in this as we can. I hope my hon. Friend will modify the morbidity he has left in my soul in this connection.

Mr. Hastings: One of the principal objects of the General Nursing Council is to deal with the practical training of nurses, and the individuals who have the most part in that are the ward sisters. The sister tutors of the hospital deal with the theoretical training of the nurse, and the matron deals with the organisation of the nursing service generally in the hospital. Both individuals are somewhat remote from the direct, daily, personal, training of the student nurse. If anyone needs representation on the General Nursing Council, it is these people who are practically engaged all their time, or ought to be, in nurse training. I feel we cannot have too great a representation of the ward sisters who are the pivot of the whole hospital.

Lieut.-Colonel Lipton: I wish to support the Amendment. In view of the warm terms used on Second Reading in commendation of the ward sisters I am a little surprised to note the apparent reluctance of the Parliamentary Secretary to concede our request. I do not want to adopt a threatening attitude on this matter, but I should like the Parliamentary Secretary to know that four out of the five hon. Members who put their names to the Amendment are present. That almost constitutes a majority of those present, particularly if we can persuade the three hon. Members opposite to rally to our support on this matter. I would not like it to be thought that any of the arguments we have put forward in support of the increased representation of ward sisters are to be regarded as in any way critical of hospital matrons. Even within the privileged walls of this assembly, I should hesitate to criticise the matrons of our hospitals—

Mr. Sorensen: Does that mean that my hon. and gallant Friend is as frightened of them as are some nurses?

Lieut.-Colonel Lipton: I think it would help to make the work of the Council much more effective, and perhaps much more democratically representative of this very important section of the nursing profession, if the Minister were to concede this Amendment. Even if he does so, while he is tied as to 10 out of the 12 appointments which are within his power, he will still have a free hand as to two of the appointments. In those circumstances, I ask him, in view of the admittedly high regard in which everyone holds the contribution made to the hospital service by the ward sister, to grant this small concession.

1.45 p.m.

Mr. Diamond: I hope that my hon. Friends on this side of the Committee will not think me lacking in logic if I say that I find myself in considerable sympathy with the Parliamentary Secretary's desire not to be compelled to fill three vacant places from six or seven appointees of one sort or another. The series of Amendments which follow all have the same point in view—to give representation to particular classes. I also hope my hon. Friend will bear in mind everything that has been said on behalf of the ward sister and anything that may

be said of any member of the nursing world as a whole.
These different claims should be given the greatest possible consideration by my hon. Friend, but I think the General Nursing Council ought to be strengthened, and the desire of the Committee should be not to weaken it in any way. We would be weakening the General Nursing Council if we compelled the Minister to appoint from certain categories to such an extent that he was left no freedom of choice for appointing from those categories that might arise in the future and might require consideration, and those categories which exist at present but have had no consideration by hon. Members who have put down Amendments. If one wanted to include every category, one would have to move a large number of Amendments, and if we were to cover every category represented on the General Nursing Council and doing excellent work at the moment, many more Amendments would be necessary. I was interested in what my hon. Friend the Member for East Harrow (Mr. Skinnard) said about the constitution of the General Nursing Council and the fear that it may be composed of matrons—

Mr. Skinnard: Only the elected members.

Mr. Diamond: Lest that point might arise, I have taken the precaution of ascertaining precisely the categories of the individuals elected at the time of their election. The present General Nursing Council consists of 25, and I agree with the Parliamentary Secretary that the numbers have been increased almost to an unwieldy extent. Nine are appointed and, out of the 16 elected, nine are matrons and were matrons at the time of their election. If hon. Members are interested, I can give details of all the Members—

Mr. Skinnard: How many are ward sisters?

Mr. Diamond: There are nine matrons, three sister tutors, one male tutor, one departmental sister, one nurse and one engaged in administration. I hope that I have dealt with the fear that only those of one particular category would be likely to be elected to the Council if the Parliamentary Secretary were not empowered to appoint all in every case. The whole of my argument is based on this; that


there are many categories to be consulted the existence of some of which we know at the moment, the existence of some of which will arise in the future, and of which we do not know. There are certain categories coming into existence as the art of nursing develops which do not fully exist at the moment and, perhaps, are not fully recognised. My hon. Friend may at some future date wish to make appointments from those categories. In those circumstances I wish to give to him the fullest support I can in his attitude of giving the fullest possible consideration to all categories, especially those mentioned by my hon. Friends, but in refusing to be limited in his choice, and therefore in refusing to weaken the structure of the General Nursing Council.

Mr. Blenkinsop: I am glad that we have had this short discussion on this matter. There has been recognition that we have in this Bill tried to provide a reasonable amount of representation to those particular interests, if I may use that term, which certainly require and demand particular representation. We have gone further in extending that list by including one representative of ward sisters to ensure that their particular point of view should be expressed. We have no reason to believe that they will be denied automatic election but we wish to ensure that there is representation of their point of view. We cannot, however, carry this procedure much further; in fact I do not think that we can carry it any further.
Indeed I wonder whether we have not already gone too far. I believe it is wrong to insist that just because representation is granted to certain categories we must therefore automatically go on and give special representation to every other category for which a good claim can be made. I believe that there are other claims that could be made for categories which have not been put down on the Order Paper. It is wrong to work on the assumption that we must ensure by specification in this Bill the representation of every particular viewpoint. If we were to do that, we should need a General Nursing Council very much larger than it is at all practicable to have. We should also, as my hon. Friend the Member for Blackley (Mr. Diamond) has pointed out, deny the Minister the right which he must have of considering the many claims to

representation that there are, and, in view of the conditions of the time and our developing experience in the nursing world, to make such appointments as he feels are right and proper.
I give my hon. Friend the assurance that we have carefully considered this matter. The fact that we have included one representative of the ward sisters shows our anxiety and desire to see that their viewpoint is expressed. That does not mean that because we give particular representation to one category we must automatically immediately double that representation or possibly treble it; otherwise we shall be placed in a hopeless position. I give my hon. Friend the assurance that, in considering appointments in what I will call the free list within the discretion of the Minister, we are bound to take account of the views expressed here, and the need for representation both by ward sisters and by others, claims for whom have been put down on the Order Paper, who also have a fair claim to representation. We must do our best to see that all these points of view are covered within the powers which the Minister has.

Mr. Sorensen: Are we to assume meanwhile that despite what my hon. Friend has said about the undesirability of specifying particular categories, he attaches so much importance to nurses in the National Health Service that he feels that in that case there must be two appointed by him, and that therefore they are more important than ward sisters?

Mr. Blenkinsop: I strongly deprecate the attempt by hon. Members, which I think is most unfortunate, to try to evaluate the work of particular categories of nurses in this way. They are working as a team and it is quite wrong to insist that one particular category is doing more important work than another.

Mr. Sorensen: It is in the Bill.

Mr. Blenkinsop: They are all doing work of great importance. There is insistence in the Bill on representation for the work of nurses in the local authority field because it is a different kind of work altogether from that being done by other sections which are represented, and it is of the utmost importance that they should be represented.
Because we have provided for special representation in a limited number of cases my hon. Friends must not insist on the gradual expansion of that list and so destroy the whole value of the General Nursing Council. If we were to accept this proposal—and I shall in a moment or two be pressed to accept one or two proposals of a like character—there would be no discretion left to the Minister in making appointments; he could take no account of changes and developments that might take place and we should certainly be building up a Council far too large and unwieldy. In spite of the very real understanding and knowledge which we all have of the work which is being done by ward sisters and every other category of nurse in this field, I hope that hon. Members will not impute to me the motive that we are regarding the ward sister or any other category as less important in the service which they are giving in the general medical field in this country.

Mr. Skinnard: I concede that my hon. Friend has tried to be helpful and sympathetic but I wonder whether he would help me a little further in one respect? Does he consider that having a certain number of unallocated places at the Minister's disposal for nomination is a valuable way of balancing any undue preponderence of one type of representation on the elected side? If that is so, can he tell me whether the Minister is to make his appointments before or after the elections, because if the appointments are to be made before the elections the argument does not hold water? If regard is to be had as to the result of the elections before the Minister makes appointments, I will concede that my hon. Friend has made a very good case indeed for elasticity in making the appointments.

Amendment negatived.

Mr. Howard: I beg, to move, in page 14, line 16, at the end, to insert:
(f) two shall be registered medical practitioners.
This is a point of much greater substance. It is not one of what subdivisions of a particular profession shall be represented but of what professions shall be represented. Everyone who has had anything to do with dealing with the sick in hospitals or has had anything to do with nursing will agree that the

best results are obtained only where there is the closest possible working between the medical man and the nurse. We all desire to see that prevail throughout the whole country. It is of the greatest importance that in the case of all these bodies which are considering the general problem of nursing, and particularly the training of nurses, there should be available immediately at hand medical men who are actively engaged in working alongside these people.
2.0 p.m.
I will not say more except that when this point was raised in another place the Government spokesman there made it clear that he took a rather favourable view of the point of view which had been expressed. Naturally, he was guarded in his reply. His actual words were:
In the past, medical men have found their way on to these committees, and I think the noble Lord may rest assured that under the new dispensation there will be no change.
If the noble Lord can rest assured that under the new dispensation there will be no change, may I ask the Parliamentary Secretary to give such an assurance to this Committee, so that we also can rest assured that there will be no change?

Mr. Blenkinsop: Here, as has already been mentioned, the practice has always been that in the field of appointments of the Minister, not purely appointments where he has complete discretion, but within the other appointments of the Minister, he has always in the past assured representation of some from the medical profession. We can give this assurance, that there is no intention to depart from that general practice. For the reasons I have already advanced I would rather not tie myself to the insertion of these words in the Bill.
I still wish to ensure liberty of appointment in places which are available to the Minister for appointments; but as I think the hon. Member realises, in the past it has been the practice to make such appointments from those, for example, who have experience in administration and other fields. This is not the only opportunity for the appointment of persons representing the medical profession, but I can give my hon. Friend the assurance that we have every intention of continuing with past practice.

Sir H. Lucas-Tooth: The Parliamentary Secretary has given a quite clear assurance, and, of course, we are happy to receive that assurance. But I am not altogether happy to leave the matter as it stands. Apart from the three persons referred to under paragraph (e), and the three vacancies, it is quite clear that the Minister could not appoint doctors to this Council. All the others are nurses—I think that is right. It is true, of course, that there are other persons who are appointed not by the Minister; that is to say three persons by the Minister of Education and two appointed by the Privy Council. I think my hon. Friend made it clear that what we are concerned with is to see that the medical profession is fully represented on the Council. We are not concerned particularly with the precise wording of this Amendment.

Dr. Morgan: But why?

Sir H. Lucas-Tooth: I wonder whether the Parliamentary Secretary will give an assurance that he will look into the matter from the angle, not that of these remaining three there should be two members of the medical profession, but that he would so contrive his appointment that there will always be at least two members of the medical profession on the Council?
It may be that some words added to the Bill, either in the body of the Bill or to this Schedule, would bring about that result. It seems to me a little unsatisfactory that in a matter of this major kind we should leave the position at large, and that the representation of the medical community should in fact rest on an assurance given—I do not say this offensively—by the Parliamentary Secretary in this House. It does not seem to be the right method to deal with this matter and if some appropriate words could be found that would probably meet the wishes of both sides of the Committee.

Dr. Morgan: I am not at all sure about this point. I fail to see why the medical profession should, by statutory legislation, be included on the General Nursing Council, unless there is to be a reciprocal arrangement by which nurses will be included in the reform Bill of the General Medical Council which is pending. I have read the B.M.A. memorandum on this point with great care. I have read it as a member of the B.M.A. Council and

I shall tell them at the next meeting of the Council that I fail to see why the medical profession should ask to have representation on the General Nursing Council.
It is quite true that some doctors are very specially interested, such as those engaged in the tuition of the nursing profession. But, after all, the General Nursing Council will have certain statutory duties to perform, and I do not see where the medical profession comes in with regard to those duties. I would ask the Parliamentary Secretary to look very closely into this matter, unless he is prepared on some subsequent occasion to give nurses a reciprocal position on the governing body with regard to professional medical education. Many of the people who should be in this Bill—industrial nurses for example—are quite outside its scope. Yet we are allowing what we call the hierarchy of the profession to come into a lower grade and attempt to have representation on the General Nursing Council governing the nursing profession.
I think the Minister might handle this with a little tact, and not pledge himself in this matter. I would be very adverse to seeing the medical profession represented on the General Nursing Council.

Amendment negatived.

Mr. Hastings: I beg to move, in page 14, line 16, at the end, to insert:
(f) one shall be a person appearing to him to have had experience in the nursing of tuberculosis patients.
I feel that the nurses engaged in nursing pulmonary tuberculosis patients have a very special claim for representation on the General Nursing Council. As has already been said, whereas infectious diseases generally are of less and less importance, and of lower and lower mortality as the years go by, one cannot say that as regards tuberculosis. Indeed, the most serious disease of young adult life is tuberculosis of the lung, which causes more deaths between the ages of 15 and 50 than any other disease.
The difficulty is that we cannot get nurses to deal with such cases. I am told that at the present time we have between 5,000 and 6,000 beds in sanatoria which are unstaffed. I feel that those nurses who have had practical experience in nursing this particular disease will be


of the greatest help to the General Nursing Council, and indirectly to the Government, in explaining what is wrong at the present time and in getting more nurses to nurse this important class of case.
Tuberculosis is a peculiar disease. It is true that it is an infectious disease, but it is not infectious only for a short time. The infection may go on for years. Therefore, the nurse has to be trained to protect herself from infection and also to protect the other patients from infection. There is another important point. The psychology of tuberculosis is very curious, because tuberculosis patients change from day to day very rapidly. They are on top of the world one day and right down at the bottom the next. I therefore feel that, as the nursing of pulmonary tuberculosis cases is so specialised and as tuberculosis nurses are in such great demand today, we should be very wise if we provided for that branch of nursing being represented on the General Nursing Council.

Mr. Blenkinsop: I must confess that, of all the claims for special representation, the one that interests me most of all is that which has just been put forward, because it is perfectly true that there are particularly urgent problems in connection with tuberculosis in this country today. If I felt that it was not possible to meet this suggestion in any other way, I should be very much inclined to accept the Amendment.
I feel and hope that increasingly nurses will gain experience in this field as part of their general training. I hope the tendency will be in that direction, and that every possible encouragement will be given to it, including the vaccination arrangements which are already being made. Therefore, I would prefer that we should get the experience of this particular field of nursing from the general representation of nurses which is already provided for, and I believe that we shall do so. For that reason, I ask my hon. Friend not to press this Amendment, which is one with which I have the greatest sympathy and one which I hope we shall be able to meet in other ways.

Mr. Diamond: It seems to me that we are not appreciating the full scope of the duties of the General Nursing Council.

Its duty is not only to supervise the training of nurses, but it has put upon it the very difficult duty of maintaining the register and of dealing with human beings who have fallen into human errors and who come before the Council for its decision whether they shall be able to continue carrying out the vocation on which their hearts are set and on which their very economic livelihood also depends. It is a very serious matter for any member of the General Nursing Council to have to deal with, and I can assure my hon. Friends that it always causes the greatest anxiety to every member of the Council.
Therefore, one ought not to ask the Minister to limit his choice. He may feel disposed in future to strengthen the Council by appointing to it those who are experienced in medical nursing and also those with experience in administering justice, such as members of the Law Society, justices of the peace and other magistrates, and other people who have experience in dealing with human beings. The Council has this very difficult duty to perform in addition to other responsibilities.

Mr. Hastings: I thank the Parliamentary Secretary for the sympathetic way in which he is considering this Amendment. He pointed out with truth that in future it is to be hoped that all nurses with a general training will have had experience in the nursing of tuberculosis. That is a hope which we all share, but that is not the case at present, and it might be more helpful in bringing about that nappy state of affairs that one or two nurses on the General Nursing Council should have had actual experience of nursing tuberculosis cases. In view of the statement of the Parliamentary Secretary, however, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

2.15 p.m.

Mr. Diamond: I beg to move, in page 14, line 20, to leave out from the beginning, to the second "and," and to insert:
a scheme to be formulated by the Council and approved by the Minister and the.
The words at present used in the Schedule seem to be copied directly from the previous Act, and they refer to elections taking place in accordance with the prescribed scheme. Although we have


already accepted an Amendment dealing with the meaning of the word "prescribed," I understand that that Amendment can only be effective where a scheme has already been prescribed, and not in the, case where a scheme has yet to be prescribed. It means that in the case where a scheme will be prescribed in future the rules will be laid before the House. At the moment, the reference to a prescribed scheme simply means, according to the dictionary, a scheme which is "before written." I have searched this Bill to find anything to fit that definition, and I have not succeeded.
It seems to me that we cannot have these words as they stand at present, because there is no scheme which can guide the Council in its election. It is very necessary to find other words for this purpose. Under the procedure which has taken place hitherto, the scheme has been formulated by the Council and approved by the Minister, and that is what is proposed in this Amendment. It is appreciated that, under that arrangement, a scheme which was formulated and approved would not appear before the House, and I, as an hon. Member of the House, am most anxious that the control of the House should extend as far as is reasonably necessary and proper. At the moment, we have no "before written" scheme before us, and the Minister will have to put words into the Bill to enable the Council to know how they are to carry out an election.

Mr. Blenkinsop: I am very willing to have a further look at this matter. It was our intention that there should be an opportunity for the House to see a scheme laid down. Whether that is wholly necessary or not, we feel that, under the changed constitution of the General Nursing Council, it might be of value in future, in view of the particular problem of election that would arise; but I am very willing to examine the matter again and particularly to see whether the wording is adequate to carry out our intentions. If any further variation is needed before Report stage, we will make the necessary alteration.

Dr. Morgan: I hope the Minister will not accept this Amendment. I listened very carefully to my hon. Friend the Member for Blackley (Mr. Diamond), and he seems to me to be quibbling as

to what is prescribed. The terms of his Amendment are, "a Scheme to be formulated by the Council." The Council is not in existence yet, so how can it formulate something when it is not in being? The election of the Council, according to the Minister, will take place in a prescribed manner. I hope the Minister will go ahead with this scheme. If he cannot do it by regulation he can certainly prescribe it, and if that is done it can be done in a prescribed manner.

Mr. Diamond: I have the greatest possible respect for my hon. Friend the Member for Rochdale (Dr. Morgan) and there is a warm friendship between us. However, he was not able to be here earlier when an Amendment was accepted which made it quite clear that "prescribed" does not mean prescribed according to the General Nursing Council. Therefore, I was inviting my hon. Friend to do something more. In view of the Parliamentary Secretary's assurance, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Amendment made: In page 14, line 28, leave out "general elector," and insert "of the general electors."—[Mr. Blenkinsop.]

Mr. Diamond: I beg to move, in page 14, line 33, after "Council," to insert
to be elected in accordance with the foregoing provisions of this Schedule.
The purpose of this Amendment and that to line 34, which follows, is to ensure that the working of the General Nursing Council shall not be interrupted at any time because the whole of its membership, both elected and appointed, go out of office at the same time. I made this point clear on Second Reading, and I am sure it is not necessary for me to do more than to say that it seems to me that in a body of this sort it would be most undesirable if there should be this possible interruption. The only way of avoiding it would be for those who are elected and those who are appointed to overlap. The way of achieving that is that those who are elected should in no case be interfered with at all, but those who are appointed should be appointed for three years and thereafter for five years. In that event for the first three years those who are


elected and those who are appointed would be serving together and in the next two years there would be some of the originally elected members serving with the newly appointed ones. In this way there would be some members on the new Council who would be members of the previous Council, so that the continuity of the work would be assured.

Mr. Blenkinsop: We are quite in agreement with the object of this Amendment, though we would like to reconsider the precise form in which it should be carried out. On the understanding that we will bring forward a fresh wording on the Report stage, I trust my hon. Friend will withdraw his Amendment.

Mr. Diamond: I am most grateful to my hon. Friend, and I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Diamond: I beg to move, in page 15, line 9, after "may," to insert
sell mortgage charge lease surrender exchange or otherwise.
This is a legal Amendment which is being put forward because the General Nursing Council are advised that the words in the Schedule do not give them the authority to do things which I am sure every Member of the Committee would wish them to have the authority to do. The words at present in the Bill refer to disposing
as they think fit of any property acquired by them.
I ask my hon. Friend either to accept this Amendment or to give me his assurance that the words as they stand in the Clause do include
sell mortgage charge lease surrender exchange or otherwise.

Mr. Blenkinsop: I am very glad to be able to give the assurance for which my hon. Friend asks. I am quite clear that these words are included already and are covered in the wording of the Clause.

Mr. Diamond: Having regard to that assurance, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Schedule, as amended, agreed to.

Second Schedule.—(STANDING NURSETRAINING COMMITTEES.)

Amendments made: In page 15, line 44, after "payments," insert "as may be specified in the order."

In page 16, line 6, leave out front first "be," to end of line 7.—[Mr. Blenkinsop.]

Mr. Diamond: I beg to move, in page 16, line 14, at the end, to insert:
Provided that no person shall be qualified to audit the accounts referred to in sub-paragraph (d) of this paragraph unless he is a member of one or more of the following bodies:

The Institute of Chartered Accountants in England and Wales;
The Society of Incorporated Accountants and Auditors;
The Society of Accountants in Edinburgh;
The Institute of Accountants and Actuaries in Glasgow;
The Society of Accountants in Aberdeen;
The Association of Certified and Corporate Accountants;
The Institute of Chartered Accountants in Ireland."

Might I in this connection divulge my interest in bringing this matter forward? It is that I am a member of the Institute of Chartered Accountants. This is brought forward because it is felt that the Minister would wish that the audit of these accounts should be carried out by proper professionally qualified persons, and it is with the support of all the socities named in the Amendment that I put this forward. I hope, therefore, that my hon. Friend will be able to say either that this Amendment is acceptable to him, or that, instead of dealing with the matter in the Bill, it can be dealt with under the rules, when he will have regard to the societies mentioned in order to see that the one thing which all sides of the Committee desire is achieved, namely, that these accounts are audited by properly qualified people.

Mr. Blenkinsop: It would be difficult for me either to include these words in the Bill or to give a complete assurance that we will accept this Amendment and include it in the rules to be issued, for the reason that the most convenient and economical way of carrying out the audit would obviously be to use the auditors appointed by the Minister to audit the accounts of the regional hospital boards and boards of governors. Obviously, the two accounts would be so closely allied


that there is every reason why, economically and administratively, the audit should be done by the same people. For that reason, while we will certainly have regard to the points made by my hon. Friend, I am afraid I cannot give a guarantee specifically in the terms he asks.

Mr. Diamond: In view of the fact that my hon. Friend has not been able to give a greater assurance than he has given, and as this matter requires careful consideration, I regret that I am not able to seek the approval of the Committee for the withdrawal of this Amendment, although perhaps I had some idea of what would happen to it.

Amendment negatived.

Motion made, and Question proposed, "That the Schedule, as amended, be the Second Schedule to the Bill."

2.30 p.m.

Mr. Howard: There are three points which I wish to make very briefly. The first is to remind the Parliamentary Secretary of the very clear assurance he has given that the majority of the members of each of these committees shall be members of the nursing profession. I still hope that between now and the Report stage it will be possible to find some words which, when inserted in the Bill, will give added power to the assurance. I realise the difficulty, but I still hope.
My second point is that I fully appreciate that the size of these committees will probably have to vary as between area and area to suit their particular conditions, but I hope that the proportions of the various interests will be constant so far as is possible throughout these committees. There are three categories—if I may use that rather unpleasant word—principally concerned. The first is the General Nursing Council, the body which has to look after the general maintenance of nursing standards; the second category is the hospital management committee where the training has got to be carried out, and the third category concerns the consumer interests in particular—the people who are going to benefit from the service of the nurses when trained.
I should like to see these paragraphs (a) to (g) as set out in the Schedule compartmented into three categories, to

ensure that the proportions of those three interests should be preserved throughout each committee wherever it is situated.

Mr. Blenkinsop: As to the first point that the hon. Gentleman has raised, I am very glad to repeat the assurance which I gave on the Second Reading, that we intend to ensure that there shall be a majority of members of the nursing profession on these regional committees. I assure the hon. Gentleman that we have given a great deal of consideration to ways of wording this provision to ensure that it will be understood generally, but so far we have found it impossible to devise a suitable form of words.
With regard to the second point, I think the hon. Gentleman will agree that, as I said on the Second Reading, the conditions from area to area vary considerably, and I am not at the moment certain that they will not also vary in the need and weight of representation of one interest as against another from one region to another. I do not at the moment feel able to give the assurance for which the hon. Gentleman asks, although it is a matter which I shall bear in mind.

Mr. Howard: I would agree with the Minister if he were referring to a particular interest within the three general categories that I was mentioning. I agree that there must be variations. But does the hon. Gentleman think that there must be differentiations between those three general categories themselves?

Mr. Blenkinsop: I am thinking of the example of the position in London as compared with other areas. It seems to me that it is quite possible—I will not put it higher than that—that there may be special features which may require special consideration. However, I will bear the hon. Gentleman's point in mind.

Question put, and agreed to.

Third Schedule.—(THE MENTAL NURSES COMMITTEE.)

Mr. Blenkinsop: I beg to move, in page 17, line 9, to leave out from "a," to "such," in line 10, and to insert "chief male nurse of."
This Amendment is proposed because the expression "chief male nurse" which originally appeared in the Bill was taken out in another place for drafting reasons,


as it was thought that the descriptive words substituted were clearer. But we find that we have made a mistake. Male nurses have regretted the disappearance of the title for reasons of prestige, and having regard to the status of the chief male nurse in mental hospitals as the equivalent of matron on the male side, it is now thought to be advisable to reinsert the title which is defined by an earlier Amendment.

Amendment agreed to.

Further Amendments made: In page 17, line 24, leave out "be filled."

Line 25, after first "Minister," insert:
be filled by a person appointed.

Line 26, after "case," insert:
shall be filled by a person appointed.

Line 26, at the end, insert:
(2) Where a vacancy occurs in the place of a member that was originally filled by a registered mental nurse elected to membership of the Council by registered mental nurses, the person appointed to fill the vacancy shall be the person appointed to fill the corresponding vacancy on the Council, and a person appointed to fill any other vacancy shall possess the same qualifications as that by virtue whereof the person who originally filled the place vacant was qualified for appointment or election under paragraph 1 of this Schedule."—[Mr. Blenkinsop.]

Schedule, as amended, agreed to.

Fourth Schedule.—(ENACTMENTS REPEALED.)

Amendment made: In page 18, line 7, leave out from "from." to "referred," in line 8, and insert:
the date of the first coming into operation of such rules as are."—[Mr. Blenkinsop.]

Schedule, as amended, agreed to.

Bill reported, with Amendments; as amended to be considered upon Monday next and to be printed. [Bill 193.]

Orders of the Day — TELEGRAPH BILL

Considered in Committee.

[Major MILNER in the Chair]

Clause 1.—(REPEAL OF PROVISIONS OF S. 5 OF ACT OF 1940 RELATING TO LOCAL TELEGRAPH AUTHORITIES.)

2.37 p.m.

The Postmaster-General (Mr. Wilfred Paling): I beg to move, "That the Clause stand part of the Bill."
Hon. Members will be aware that last week on the Second Reading I explained that the purpose of this Bill is to relieve Hull of a certain surcharge which was imposed during the war in the 1940 Act as a contribution by them to the war effort. We feel that the time has past when Hull should be expected to pay this surcharge. Clause 1 provides for the repeal of that Section of the 1940 Act which applied to this surcharge.

Question put, and agreed to.

Clause ordered to stand part of the Bill.

Bill reported, without Amendment read the Third time, and passed.

Orders of the Day — HOUSE OF COMMONS (REDISTRIBUTION OF SEATS) BILL [Lords]

Considered in Committee.

[Major MILNER in the Chair]

The Chairman (Major Milner): The Committee will appreciate that this is a Consolidation Bill, and with the permission of the Committee, I propose to take the Clauses and the Schedules en bloc.

Clauses 1 to 9 ordered to stand part of the Bill.

Schedules agreed to.

Bill reported, without Amendment; read the Third time, and passed, without Amendment.

Orders of the Day — REPRESENTATION OF THE PEOPLE BILL [Lords]

Considered in Committee.

[Major MILNER in the Chair]

The Chairman: As this is a consolidation Bill, perhaps the Committee will agree, except in the case of Clause 55, to which an Amendment has been put down by the Secretary of State for Scotland, to the Clauses being taken in groups.

Clauses 1 to 54 ordered to stand part of the Bill.

Clause 55.—(APPOINTMENT OF ELECTION OF AGENT.)

The Joint Under-Secretary of State for Scotland (Mr. J. J. Robertson): I beg to move, in page 49, line 43, to leave out "the prescribed officer," and to insert:
such officer as may be prescribed by the Court of Session by Act of Sederunt.


This is little more than a drafting Amendment. Its purpose is to bring the Bill into conformity with the existing law in Scotland.

Amendment agreed to.

Clause, as amended, ordered to stand part of the Bill.

Remaining Clauses ordered to stand part of the Bill.

Schedules agreed to.

Bill reported, with an Amendment; read the Third time, and passed, with an Amendment.

Orders of the Day — CIVIL AVIATION BILL [Lords]

Considered in Committee.

[Major MILNER in the Chair]

The Chairman: This is also a consolidation Bill.

Lieut.-Colonel Sir Thomas Moore (Ayr Burghs): Are we to have no information on these Clauses which are to be lumped together?

The Chairman: I have informed the Committee that it is a consolidation Bill. As these Bills merely consolidate the existing law, it is not usual for the Clauses to be debated, unless Members have some special point in mind.

Clauses 1 to 71 ordered to stand part of the Bill.

Schedules agreed to.

Bill reported, without Amendment; read the Third time, and passed, without Amendment.

Orders of the Day — EXPIRING LAWS CONTINUANCE (No. 2) BILL

Bill read a Second time; committed to a Committee of the Whole House for Monday next.

Orders of the Day — EXPIRING LAWS CONTINUANCE (No. 2) [MONEY]

Considered in Committee under Standing Order No. 84.—(King's Recommendation signified.)

[Major MILNER in the Chair]

Resolved:
That, for the purposes of any Act of the present Session to continue certain expiring laws, it is expedient to authorise the payment

out of moneys provided by Parliament of such expenses as may be occasioned by the continuance of the Cotton Manufacturing Industry (Temporary Provisions) Act, 1934, the Road Traffic Act. 1934, and the Population (Statistics) Act, 1938, until the thirty-first day of December, nineteen hundred and fifty, and of the Rent of Furnished Houses Control (Scotland) Act, 1943, and the Furnished Houses (Rent Control) Act, 1946, until the thirty-first day of March, nineteen hundred and fifty-one, being expenses which under any Act are to be defrayed out of such moneys.—[Mr. Glenvil Hall.]

Resolution to be reported upon Monday next.

Orders of the Day — AIR-RAID SHELTERS (DEMOLITION)

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Snow.]

2.47 p.m.

Mr. George Wigg: I wish to raise the question of the Government's policy in connection with the demolition of air-raid shelters, with particular reference to my own constituency. The policy is based at the present time on an answer to a Question by the Home Secretary, who said:
Local authorities have been instructed to suspend all shelter demolition for the time being, though certain exceptions are being allowed, where necessary, in the public interest."—[OFFICIAL REPORT, 4th November, 1948; Vol. 457, c. 1003.]
That statement followed a period during which the demolition of shelters had been suspended after the publication of the White Paper on Capital Investment about a year before. Up to that time local authorities had been free to get on with the job of demolishing air-raid shelters, subject to manpower limitations. There had been a standstill for financial reasons and because labour was not available; the policy was then suspended and there was a temporary let up, but finally the Home Secretary decided that air-raid shelters should not be demolished.
I have the honour to represent a constituency which is almost wholly industrial. It was there that the Industrial Revolution started. Housing conditions are very bad. They are very bad for historical reasons, and because Dudley was cursed between the wars with a Tory Council who for years so neglected their duty as to do little or nothing to demolish those abominable slums.
I propose, as part of my case, to read some extracts from an annual report of the Medical Officer of Health for Dudley, which was published just before the war, and in which he reviewed the health service from 1922 until 1939. I hope the House will forgive me for a rather long quotation, but it is necessary for me to make it, to underline the plight in which some of my constituents find themselves. Dr. Blaker wrote:
Housing has been, however, the biggest and most important and urgent problem in Dudley. As I have stated earlier the mass of the houses for the working classes in Dudley in my early days were deplorable and of a very low standard. Much of the disrepair and dilapidations of individual houses was due to an utter and almost criminal lack on the part of the landlords to do their duty. But more astonishing than this was the gross failure of the responsible officials to exercise their powers through the Council, in compelling the landlords on pain of prosecution, to carry out all necessary repairs.
Then he goes on:
Of course, the houses were old—many of them were put up during the period we call the "Industrial Revolution," and so they could not be made into new houses, but my point is that they could have been kept in a reasonably fit condition for habitation by necessary and timely repairs.
Then he says this:
In searching the annual reports of the Borough, prior to 1929, one is amazed by the sanitary records in relation to Housing matters. For instance, in 1923, 1924 and 1925 there were no closing orders or demolition effected for unfit houses. In 1926 there were only four, in 1927 only one and in 1928 there were 11.
He concludes this section of his report by saying:
It is difficult to understand how such statements could have been put into print when there were simply many hundreds of houses unfit and indeed in a dilapidated condition.
That is the background of the story, and today in Dudley, of 16,000 houses no fewer than 4,600 are not really fit for human habitation. They are over 70 years old; they are structurally unsound. Of course, if the Conservative Party, which was in the majority on the Dudley Council in the years immediately following the first world war, had done its duty, those houses would have been pulled down, and there would have been no urgent problem about air-raid shelter demolition as there is today.
It may seem difficult to see the connection between the quotations I have

made and the question of the demolition of shelters. I will explain. I have been round to see these houses, and I feel ashamed that human beings should be asked to live in those conditions—abominable and appalling conditions. In some cases immediately outside the back doors are pitched air-raid shelters. I am not blaming anybody for the erection of those air-raid shelters in those particular places because the Midlands were subjected to rather heavy enemy action in 1940, and, therefore, the air-raid shelter policy was to put up some sort of protection as quickly as possible. However, many of those shelters shut out the light, and shut out ventilation, and they prevent the poor housewives from access to any area in which they can dry their clothes. Moreover, there is nowhere for the children to play.
While I appreciate and understand the present air-raid shelter policy, looking at the country as a whole, I do ask the Under-Secretary of State to take into account the special circumstances which arise from the application of the standstill policy in the demolition of air-raid shelters to an industrial area like mine. It is not part of my task or duty to speak for Birmingham, but what I have to say about Dudley applies with equal force to areas in Birmingham which, partly for historical reasons and partly because of the results of the deliberate policy of the Conservative Party, are still left with obsolete houses which ought to have been destroyed a generation ago.
As I say, I have had many cases brought to my notice, and I have been round to see those air-raid shelters. I have had an extensive correspondence with the Home Office and its officials in order to get something done about it. It is only because I have met with difficulty that I seek now to raise the matter on the Adjournment today.
As I see it, the Home Secretary decided that, in view of the international situation, those air-raid shelters must not be demolished because, of course, of the threat of a possible future war when the shelters might be of use. However, I want to say to the right hon. Gentleman that it is of little use to provide shelter to protect people against the possible effects of some atom bomb which may be dropped at some time in the future, if in the meantime they are to die of


tuberculosis, or be crippled by rheumatics, or otherwise have their health impaired as a consequence of the existence of the air-raid shelters. It is no good to measure something which may happen in the future against an absolute certainty—against what certainly will happen if some of those shelters are not got rid of.
By chance I can drive my point home because of my right hon. Friend's policy in another connection. In the next Parliament I shall represent in this House not only Dudley but Stourbridge.

Viscount Hinchingbrooke: The hon. Member will not be here.

Mr. Wigg: I value my chances very much better than the noble Lord's, because even in his part of the world one cannot fool all the people all the time. But that is by the way.
The point I was about to make is that Stourbridge, which I shall represent, has no acute problem as we have in Dudley. I wrote to the Town Clerk of Stourbridge and asked about the Home Secretary's policy, and how it bore on Stourbridge, and he tells me that there are approximately 600 surface shelters still not demolished. The Council's instructions from the Home Office being what they are, they have done no work in the demolition of those shelters. But there have been no complaints about that at all, whereas in Dudley the Town Clerk tells me that we have some 295 domestic surface shelters. As a result of the correspondence I had with the Town Clerk he made a survey of 39 of those shelters, and that, on the basis of this sample survey, there are probably 53 objectionable shelters—objectionable, by the standard that I adopted following correspondence with the Home Office; that is to say, the shelters definitely interfere with the health and well-being of the people who have the misfortune to live in the adjoining houses.
The borough engineer said that the area he took was probably one of the worst parts of the borough, and it is quite likely that if there had been a careful survey of all the shelters the figure of really bad cases would probably be not more than 25. Of course, it is difficult to assess what is bad and what is very bad, but all I can say with regard to some of those that I have seen, which by Home Office

standards would be described as bad, is that I certainly would not like to live in the neighbouring house, and if by some misfortune I were called upon to do so I would lose no time in getting out of it.
I want to take this opportunity of paying my tribute to the wives and mothers who, in these very adverse conditions, struggle to keep decent homes together. It is something which makes me feel very humble, and at the same time very proud at being called upon to represent them in this House, and as long as I do represent them I shall never cease to raise my voice until these appalling housing conditions are put right.
I appreciate the difficulties of the right hon. Gentleman, and I see how difficult it is to amend his policy, but I want to make one or two suggestions. At the present moment his regional officers can authorise the demolition of a shelter only where it could be certified by the medical officer of health that the presence of the shelter is dangerous to health. In one case—that of 45A Cross Street, Dudley, about which I had considerable correspondence with the Town Clerk and the Home Secretary—we marked time for quite a while, because the Medical Officer of Health would only go so far as to say that the presence of the shelter was prejudicial to health, whereas the Home Office wanted the Medical Officer to say that it was dangerous to health. What is interesting about this case is that in writing about the shelter the Borough Engineer had some hard things to say. He said:
It occupies about three-quarters of the open space allotted to these houses, which are of the back-to-back type. In my opinion, this lack of space and ventilation must be detrimental to the health of the occupants, quite apart from the loss of domestic amenities such as room for drying, and I consider this shelter to be a menace to the occupants of the house.
That seems to me to be very strong. About the same time the Chief Sanitary Inspector for Dudley also had some hard things to say about it. He said:
The shelter contains a considerable amount of debris, but apart from this it is not a suitable place in which children should play. In my opinion the building should be demolished and the site cleared.
The point is that the Home Office would not move on the basis of the, to say the least, very strongly worded certificates from the Borough Engineer and the Chief Sanitary Inspector, and when


the Medical Officer of Health came along with a certificate in which, I think, the words "prejudicial to health" were used they still refused to budge. It was only after more correspondence and a little more pressure that they finally decided to give authority for this shelter to be taken down. I suggest that the borough engineer and the chief sanitary inspector of Dudley are responsible local government officers of very great experience, and when they are prepared to certify, and to give reasons for their certification, that the existence of a shelter does more than inconvenience the occupants of a house, then the Home Office ought to be prepared to let up.
The burden of my case is that the right hon. Gentleman's policy is obviously all right as far as the pleasant places are concerned—the Bournemouths, the Weymouths, the Cheltenhams and the Harrogates. It is clearly all right as far as Stourbridge is concerned, which although only a few miles away has not got the legacy of the Industrial Revolution which hangs like a millstone round the neck of Dudley. He therefore ought to be prepared to have another look at the whole problem, and he ought to realise that we are in, not the post-war period after the First World War but the post-war period after the Second World War. We now have a strong Labour Party representation on the Dudley Council; the workers there are organised, and are not prepared to occupy for ever and ever these rat-infested hovels in the interests of Tory landlords; they are going to have these places pulled down. It is silly to leave air-raid shelters standing when, with a little bit of luck, the areas themselves will be cleared and the houses pulled down. He could relate his policy to developments which are certain to occur over a foreseeable period, say, five years or 10 years.
Furthermore, he ought to modify his policy as applied to areas where there are very old back-to-back houses which, by modern standards, are not fit to live in. The figure which I have given of 4,600 houses as being unfit is not my figure and it is not a guess. It is taken from a survey made by people associated with Birmingham University who surveyed the dwelling standards of the Midlands. The Under-Secretary of State may be able to find a formula to link up his

demolition policy with the density of houses per acre. In Birmingham the density is 40 houses per acre. The next nearest density figure is 33 houses per acre in Dudley which can match for bad housing conditions almost anything that Birmingham has. The Minister could say that in any area where the density was beyond some figure which he could determine, he would be prepared to authorise the local authorities forthwith to remove the shelters. Clearly, if there is a high density of population per acre it points to the fact that the property is very old and that there is hardly anywhere that the shelter can be placed without interfering with the light and ventilation of the occupants of the houses. Most important of all, there is absolute certainty that these houses will have a short life, and will soon be coming down.
I am sorry if I have wearied the House by looking at these matters from a constituency point of view. I am putting forward some of the difficulties of my constituency, and I am certain that if the hon. Gentleman will adopt a more liberal policy he will be benefiting people who, with great patience and fortitude, are living in conditions in which they ought not to be asked to live. The quicker that these conditions can be terminated the better, Until then, I beg to ask the Under-Secretary to do what he can to ease the situation and to make things a little better than they might otherwise be.

3.8 p.m.

Major Vernon: Before the Under-Secretary of State replies may I ask him to consider the related and slightly different problem of the static water tank, particularly in South London. We have got rid of most of our air-raid shelters, chiefly by the activities of the London County Council, but the tanks are still all over the area and some of them are near to schools. They are a temptation for people to throw their rubbish in, and people have complained to me of smells coming from the tanks. Occasionally, school authorities have had to ask the Fire Service to pump the water out of the static tanks. With the rain coming on again, the whole business will start once more. I shall be glad if the Under-Secretary could give his attention to his matter


when he replies to my hon. Friend the Member for Dudley (Mr. Wigg), who has made a plea for his constituency.

3.10 p.m.

Wing-Commander Millington: I should like to make one or two observations on this subject, which, with respect to my hon. Friend the Member for Dudley (Mr. Wigg), has a national application. As he so rightly said, the policy of the Government was laid down in 1947. There are three kinds of reasons which have not yet been made perfectly clear which may have guided my right hon. Friend the Home Secretary in making his decision at that time.
The first reason is apparently, that it arose out of the White Paper on the national economy and that the purpose of adumbrating the current policy was simply the importance of keeping to a minimum, capital expenditure on works of this character. In the light of current developments, it is quite understandable that that reason is as acute today as it was two years ago or even more so. The second reason—and this is something which my hon. Friend the Member for Dudley should have in mind—is that the same kind of labour force is required to demolish as to construct a building. I would like to know whether there are any figures on this subject of the extent to which the positive building programme might be slowed down if the policy regarding air-raid shelters were altered; in particular, to what extent the constituents of my hon. Friend would have to wait for their slums to be demolished if the air-raid shelters blocking their entrances were now to be pulled down.

Mr. Wigg: The White Paper on Capital Investment in 1948 (Command 7268) states, after paragraph 47, that the total labour force allocated to the Home Office for the whole country in June, 1947, was 6,683, and that the maximum set for that labour force for June, 1948, was 2,500. I am not unaware of the point which my hon. and gallant Friend has mentioned but, clearly, it is a very small matter.

Wing-Commander Millington: I am grateful to my hon. Friend for producing the figures. My third point, however, which gives some of us a little more concern, is whether the decision which was reached in 1947 was arrived at because

it was felt by the Home Office that the air-raid shelters erected during the recent war constitute, in the opinion of the Home Office, adequate protection against the kind of air warfare which might be waged should there be a future war. Does the Home Secretary think that we must stop pulling down these eyesores, which have all the objections to which my hon. Friend has referred, because it is part of our new A.R.P. policy to keep them in situ?
I warn the country quite strongly against sharing that view. Albeit that many lives were saved during the recent war by surface shelters against blast and the like, there is every indication that should there be a third war, a war waged with the weapons of aerial destruction which are now in existence, the existing shelters are likely to be as much of a safeguard as the brown paper that on a certain other occasion we were recommended should be wrapped around people's bodies to ward off the rays from atomic explosion. I would like to feel that the Home Office were well aware that this kind of shelter from air-raids is completely obsolete, and that if any new shelter policy is undertaken it will be based on far more up-to-date and realistic considerations of the risks against which we have to protect our people.

3.14 p.m.

The Under-Secretary of State for the Home Department (Mr. Younger): I am grateful to my hon. Friend the Member for Dudley (Mr. Wigg) for having raised this matter on such a moderate note. In the Home Office we are very well aware of the grave inconvenience, to put it no higher, which is caused, particularly in the sort of area about which my hon. Friend was speaking, by the policy which has been adopted of not continuing the demolition of these shelters.
The difficulty arises chiefly from two or three different considerations. I do not think I need argue all the reasons. First, there was the proposition, which, I think was agreed to by all parties in the House when the new Civil Defence Bill was under discussion, that the time had come when we should be taking some reasonable precautions with regard to any future emergency involving air raids, and that we should try to do so with the minimum diversion of effort from new buildings. I think that was accepted. It was partly


due to the financial difficulties, the capital investment programme and so on, that the provision for demolition of shelters had to be so small. Quite independently of that, even if there had been a slightly less critical situation, this House would probably not have wished to see any considerable diversion of manpower or of materials from the work of construction into work of demolition. The third reason why this arises—and this applies particularly to certain parts of the country—is the one which my hon. Friend stressed, the state of housing. I will return to that in a moment.
May I recapitulate briefly, although my hon. Friend did it accurately, what has been the policy about demolition since the end of the war? From the end of the war until the Autumn of 1947, no restrictions were laid down upon the demolitions which local authorities could undertake. Then in the Autumn of 1947 there was a standstill and the demolition was restricted to the demolition of dangerous structures and of shelters whose demolition might enable us to recover certain quantities of steel.
In the months immediately after that policy had been announced, early in 1948, the policy was slightly eased to include special cases where there was danger to health. Then in October, 1948, that demolition was stopped subject to provision for certain special cases. This was made clear in the answer of my right hon. Friend to which the hon. Member for Dudley referred. May I read from the instruction sent to the Home Office principal officers in the different regions on that point at the end of September, 1948. After setting out the legitimate cause for complaint that might arise in many instances from stoppage of demolition, this went on to say:
The Secretary of State is prepared to agree to your approving reasonable expenditure on minor remedial measures to remove such inconveniences—
Under that part of the policy one could reasonably hope to deal with minor alterations that would have to be made, for instance, to make a shelter safe from playing children—
and even in very exceptional circumstances to the removal of a particular shelter or emergency water installation.
That is the policy under which we have been operating for the last year, since the

end of September and early October. 1948.
So it will be seen that there was a period after the war when local authorities had a free hand to deal in whatever order of priority they thought fit with the demolition of the most undesirable shelters. I am not suggesting that it is any criticism of them that in some areas they were not able to get rid of all the bad shelters for that was probably not possible, but it is fair to assume that the most undesirable ones—the ones to which the health authorities took the gravest objection—were probably, even in the most difficult areas largely demolished in the period between 1945 and 1947.
I was asked whether we could not, in allowing for these exceptions, be rather more liberal in our definition. My hon. Friend pointed out that what we require is evidence of danger to health, and he quoted a case in which we had been discussing a shelter in Dudley with him where the Medical Officer of Health was not prepared to say that, but was prepared to say something near that. In fact I think he used the words, "Prejudicial to health." I am sure my hon. Friend will appreciate how difficult it is to depart from a clear conception such as "dangerous to health" and to use vaguer words like "prejudicial" or "inconvenient." It is very difficult to do other than stick to what is, I think, a fairly recognisable medical standard of a shelter which will be actually dangerous to the health of the inmates.
What we have to remember about communal shelters, particularly as against the individual back-garden shelter, is that it is for the protection of a group of people and very often the inconvenience and prejudice is only suffered by one or two. Although one has every sympathy with the individual who happens to suffer, one is obliged to adopt a different attitude with regard to a shelter which would serve 10 houses and only prejudice one than in regard to a shelter in which the only person whose protection is involved is applying for removal.

Mr. Wigg: My hon. Friend mentioned that danger to health is a recognisable medical term, but it is part of my case that this is not a medical problem but an engineering problem, an ascertainable problem. The question whether there is


sufficient ventilation and sufficient light is decided on standards laid down by the Ministry of Health or the Ministry of Education in regard to schools and it is not laid down by doctors, but by architects and engineers. I deplore the keeping of this problem out of the hands of the borough engineer and the sanitary inspector, who are going round the districts all the time and have to tackle the problem, and then turning the matter over to the medical officer of health and putting it in the extreme form. The medical officer of health, being an honest man, shies a little from the word "danger" because it rather suggests that if he did give a certificate he would be caught out if the patient did not die. I object to that.

Mr. Younger: I am sorry my hon. Friend objected to the way I put it, but I should think that where we are discussing questions of health, although I suppose the accepted standards are laid down by architects, in part, we must also consider the medical aspects and it must be to the health authorities that we should look for advice as to the effect on health of a particular structure.

Mr. Wigg: Will my hon. Friend consult with the Minister of Health and the Minister of Education and ascertain from them the standards of heating and lighting they require and not sanction the erection of a building which does not satisfy the technical officers of medical officers? That would seem to settle the question.

Mr. Younger: I am very happy to ask for any information of that kind, but I think it would be inconceivable that any advice given by those technicians had not been co-ordinated with medical opinion. Surely the amount of light and air required must be in part a medical opinion and no architect could lay down a standard completely independent of medical opinion. He may be given certain medical criteria and, with his expert knowledge of building, he may apply some kind of standard, but it is impossible to argue, when we are trying to lay down criteria of health, that we should ignore medical advice and go only to architects and engineers. I put it no higher.
Passing to another point which particularly affects the main argument of my hon. Friend that because in his area,

as in certain other industrial areas, housing is particularly bad the policy in regard to the demolition of shelters should be eased, in those areas, as opposed to more fortunate areas, I entirely agree with him that housing in the area of Dudley and other industrial towns where this problem arises most acutely, is lamentable. It is precisely because the areas are so lamentable, because the houses are of a particular kind, very old and very often back-to-back property, and because there are so very few open spaces, that it was necessary to put the shelters in positions which could never have been considered satisfactory. Even at the time they were put there they were put there for one reason only, simply because there was nowhere else they could go and protection of some kind had to be provided in the area.
With all that I entirely agree. It is that which causes our problem here. I should like my hon. Friend, however, to consider a little further the implication of his suggestion that when one is dealing with an area which is unfortunate in this respect one should therefore demolish shelters more freely. These areas will not be less in need of shelter protection if trouble comes than any other better area, say, in Bournemouth, or wherever it may be. Unless one is prepared to find some other means of providing shelter accommodation, so long as one thinks it advisable to retain any shelter accommodation at all, one must think twice before adopting a lower standard of protection in these more highly populated areas of old housing than in the other areas. That seems to me to be the implication, whether intended or not, of what my hon. Friend said.

Mr. Wigg: I am sorry if I failed to make myself clear, and I apologise. I said that 4,600 houses out of 16,100 were so old by any standards that they ought to go. I thought that I pointed out that within a reasonable period of time—five or six years—these houses would go and one result of the rigid application of my right hon. Friend's policy would be that he would keep these shelters but the houses would have gone.

Mr. Younger: I was coming to that point. It is necessary to consider this both as a short-term and a long-term problem, but before coming to that point


I wish to complete the point I was making.
So far as my information goes, if we were to adopt generally a standard for these bad housing areas different from that which we adopt throughout the country generally, then in areas such as Dudley, to which my hon. Friend is referring, we might be involved in the demolition of a very high proportion of the total shelter accommodation. We might be leaving that area, during such time as those houses are not pulled down and cleared away, with totally inadequate protection. My information is that about 80 per cent. of all the communal surface shelters in the area are somewhat of the kind to which my hon. Friend is referring. Unless one were prepared either to take the risk, take the chance, of these areas being very rapidly cleared—they are big areas and the operation will be a major one—it seems to me that the result of immediately demolishing a large number of these shelters would be to leave these heavily populated areas practically without protection at a time when we are not in a position to build any new and better modern accommodation.
I have not any precise information about the demolition of the houses in this area, but one knows what the situation is in many areas which are scheduled under local authority plans for demolition. We all hope that these areas will be rapidly cleared but none of us know what we mean by "rapidly." No one can say whether it will be next year or the year after. It may possibly be five years hence, I do not know; I have no means of judging in regard to Dudley. It would be rash of my right hon. Friend if in considering shelter policy he were to base demolitions today on the assumption that before there could be any question of them ever being required that area of housing would have been pulled down and replaced. We must wait until we know, until the demolition work in these areas is just beginning or, if the programme is not actually in hand, until it is at any rate in immediate contemplation. I am not aware that that situation arises at the moment.
May I deal finally with the question of adequacy raised by my hon. and gallant Friend the Member for Chelmsford (Wing-Commander Millington). He said

at one stage that the shelters of the last war, in the light of an anticipated attack in modern war, were completely obsolete. That is a much more extreme view than the one received from the inter-departmental research committee which is constantly at work on this problem. This is always a very delicate subject to discuss. On the one hand, one does not wish to cause despondency about future attacks or on the other hand to appear to be in any way complacent. I think I may put it this way; that so far as our expert advice goes it is the case that good shelters of the 1945 standard are by no means obsolete for high explosive attack even on the increased scale—I am talking now entirely of high explosives—which may be anticipated; and they would be reasonably adequate to deal with any high explosive attack on the scale we knew up to 1945.
Even with regard to atomic explosions, one must appreciate that we shall have to face up to the problem of protecting people at differing distances from the atomic explosion, and there certainly is a distance from the atomic explosion at which it would be very much better to be in a shelter of the 1945 kind than to be either in a house or in the street. There would be some resistance to blast and, some protection from rays at a certain range. There is a range at which danger from an atomic explosion vanishes altogether without protection and that point will be reached more nearly if one is in a perfectly good brick shelter of the 1945 pattern than if one is in one's own house, or in the street.
Reverting for a moment to high explosive defence, I believe that in broad terms it is the expert opinion that it is three times better to be in a house than to be in the open; and it is five times better to be in an ordinary brick surface shelter than to be in a house. That is to say, it is 15 times better to be in a shelter than in the street. It is not complete protection, but it is better than nothing and it is giving protection to quite a large part of the population of any town, which happens to get heavily bombed, at an area of some reasonable distance from the explosion, even under the modern scale of attack.

Wing-Commander Millington: It would seem to me that there are two questions


which we must consider. If I understand the Under-Parliamentary Secretary correctly, he is arguing that it is part of our air-raid precautions policy to conserve some of the 1945 shelters. The first question is in relation to high explosive bombing, and the second is in relation to atomic bombing.
In relation to high explosive bombing, it is the advice of the inter-departmental committee considering this question that, in regard to any kind of high explosive bombing such as we experienced up to 1945, the brick shelters provide 15 times the safety that a man standing in the street would enjoy. But has this interdepartmental committee given a comparable figure in relation to the kind of bombing which the Germans suffered in 1945? It is not reasonable for us to base our precautions upon the kind of bombing which we received in this country—bombs of a maximum size of something like 500 kilos—unless we also take into regard the kind of bombing we were delivering ourselves—bombs of 12,000 and 20,000 lb. weight.
Surely it is a little naive of the Under-Secretary to suggest that a brick wall is any protection at all against radioactive rays of an atomic explosion. There is some protection, but none of the materials which go to make up the air-raid shelters which we are discussing today in fact provide any protection whatsoever against radioactive rays, against which we must have some form of protection.

Mr. Younger: That shows the difficulty of entering into a technical discussion. I am not going to argue the technical details with my hon. Friend, who might know quite a lot about them. I can only say that it is certainly not my advice. The suggestion that the fact of a person being in a shelter would make no difference at all is contrary to the advice I am given. I am advised that there is a radius from an atomic explosion at which these shelters could be helpful, and they are better than nothing.
With regard to high explosives, I cannot say that the proportions of three times and five times which I have mentioned would apply to the absolutely maximum high explosive that we might get under modern conditions. I think it is so, but whether those precise figures apply or not, it is undoubtedly the opinion of the

experts who have been advising my right hon. Member that the shelters of the 1945 standard are very much better than nothing and very much better than ordinary houses, particularly the types of houses which exist in these areas. One hardly needs to be a technician to see that that must be so, and it also is apparent that it must be so in the case of brick shelters against high explosives. It depends how far away the bomb is.
I should not want it to be thought that anything I am saying is to be taken as suggesting that the expert view of the Government is that the 1945 standard of protection is adequate either against the atomic bomb or against what could be expected in the matter of high explosives. All I do say is that, pending proper provision on a tremendously increased scale to meet the country's requirements, it is very much better to have what we have got than nothing at all

Mr. Wigg: I appreciate the point which my hon. Friend is making, and it had entered into my calculations before I approached the Department or raised the matter in this House. Of course, a shelter is better than nothing. What I am worried about is whether my hon. Friend has taken into account the possible use of the shelter as against the certainty of the spread of asthma, tuberculosis and rheumatism if the shelters are built outside the houses of working-class people living in bad housing conditions and thus preventing air and light getting into them.

Mr. Younger: My hon. Friend speaks of a certainty, but the provision made in 1948 for exceptional treatment was to provide for precisely that sort of thing, and it is largely a question of medical evidence. We are prepared to consider any special cases on their merits on the advice of the local medical officer of health or other qualified authority. If we are informed, and if we are satisfied on consideration of the details of the case, that in fact there is a certainty resulting from the presence of shelters that health will be injured, we will certainly give very sympathetic consideration to it. We must always have in mind to some extent whether the safety of a large number of people is involved, which has to be weighed against the possible injury to health of only a few persons, but, supposing there was reason to believe that the


lack of light and air was affecting a particular family suffering from tuberculosis, certainly that would be the type of case to which my right hon. Friend would give special consideration.
What I cannot say is that my right hon. Friend is prepared to adopt an entirely different standard. In present circumstances, we must limit very narrowly the types of shelter which can be demolished. We cannot agree to shelters in this area, where nearly all shelters are troublesome, being demolished because they are damaging to amenities. I am afraid they are nearly all that, but what precise

standard is to be fixed is a matter of great difficulty. All local authorities are aware that they can bring special cases to the notice of the principal officer of the Home Office and, if necessary, to my right hon. Friend, and we will seek to deal with these in a sympathetic manner; but I do not think it is fair to the House to say otherwise than that they must remain subject to the general conditions which I have put before the House.

Question put, and agreed to.

Adjourned accordingly at Nineteen Minutes to Four o'clock.